Sugar fermentation tests, Cetrimide agar medium, Hugh Leifson medium Shivam kumar Sriwas
Combined presentation on:-
1. Sugar fermentation tests
2. Cetrimide agar
3. Hugh Leifson medium
Covering principle, preparation of the medium, test protocol, result interpretations, test conclusions.
Lab diagnosis of Sexually transmitted Infections (STIs)Mostafa Mahmoud
This lecture was presented to the physicians dealing with the various infectious diseases specially in STIs in Riyadh Region, MOH. The lecture concentrates about the various methodology applied to diagnose STIs in the laboratory with the advantages and disadvantages of each. Hope to make benefits to all.
The presentation summarises important methods and protocols of Clinical Microbiology. It may be useful to learners of Clinical microbiology at the undergraduate label. The presentation describes the procedures for collecting clinical samples, transport, and testing. It also describes the different methods of antimicrobial susceptibility testing and standards.
Sugar fermentation tests, Cetrimide agar medium, Hugh Leifson medium Shivam kumar Sriwas
Combined presentation on:-
1. Sugar fermentation tests
2. Cetrimide agar
3. Hugh Leifson medium
Covering principle, preparation of the medium, test protocol, result interpretations, test conclusions.
Lab diagnosis of Sexually transmitted Infections (STIs)Mostafa Mahmoud
This lecture was presented to the physicians dealing with the various infectious diseases specially in STIs in Riyadh Region, MOH. The lecture concentrates about the various methodology applied to diagnose STIs in the laboratory with the advantages and disadvantages of each. Hope to make benefits to all.
The presentation summarises important methods and protocols of Clinical Microbiology. It may be useful to learners of Clinical microbiology at the undergraduate label. The presentation describes the procedures for collecting clinical samples, transport, and testing. It also describes the different methods of antimicrobial susceptibility testing and standards.
it contains how the sample is processed and how it is subjected to staiing, biochemical reactions, what are the culture medias used, and thier methods. it also includes the antimicrobial susceptibility testing
Issues in Veterinary Disease Diagnosis.pptxBhoj Raj Singh
Diagnosis of a disease or a problem is the first step towards solution/ treatment/ control/ prevention.
Diagnosis is successfully. important to determine Prevalence (True prevalence, apparent prevalence) and Incidence of the disease to estimate the disease burden so that prevention and control measures can be planned and implemented.
However, in few years with the invasion of pharmaco-politics in disease control the term got vitiated.
Epidemiological Approaches for Evaluation of diagnostic tests.pptxBhoj Raj Singh
Diagnosis of a disease or a problem is the first step towards solution/ treatment. Clinical Diagnosis or Provisional Diagnosis is the first step in diagnosis and is done after a physical examination of the patient by a clinician. Clinical diagnosis may or may not be true and to reach Final diagnosis Laboratory Investigations using gross and microscopic pathological observations and determining the disease indicators are required. The diagnostic tests may be Non-dichotomous Diagnostic Tests (when continuous values are given by the test in a range starting from sub-normal to above-normal range) and Dichotomous Diagnostic Tests (when results are given either plus or minus, disease or no-disease). To make non- Dichotomous diagnostic test a Dichotomous one you need to establish the cut-off values based on reference values or Gold Standard test readings or with the use of Receiver operator characteristic (ROC) curves, Precision-Recall Curves, Likelihood Ratios, etc., and finally establishing statistical agreement (using Kappa values, Level of Agreement, χ2 Statistics) between the true diagnosis and laboratory diagnosis. Thereafter, the Accuracy, Precision, Bias, Sensitivity, Specificity, Positive Predictive value, and Negative Predictive value, of a diagnostic test are established for use in clinical practice. Diagnostic tests are also used to determine Prevalence (True prevalence, apparent prevalence) and Incidence of the disease to estimate the disease burden so that control measures can be implemented. There are several Phases in the development and use of a diagnostic assay starting from conceptualization of the diagnostic test, development and evaluation to determine flaws in diagnostic test use and Interpretation influencers. This presentation mainly deals with the epidemiological evaluation procedures for diagnostic tests.
Types of Trials in Medicine, vaccine efficacy or effectiveness trials and rel...Bhoj Raj Singh
The importance of learning about medicines’ and vaccines’ efficacy or effectiveness trials is not only necessary to those who are developing, producing or marketing these pharmaceutical products but to the users also because: The Emergency approval of Covid-19 vaccines and many other medicines in last few years has created so much fuss to understand the reality. The lesson learnt from Covid-19 vaccine(s) by vaccine production, marketing, vaccination and finally the revenue earned by vaccine developers and producers, and political gain by politicians, is proving deleterious to the society as several vaccine(s), useless or scarcely proven safe and useful, are going to infest and some have already infested the market (the health industry). So reading this presentation may be useful to you so that you may question the authorities if any is engaged in bluffing you. The presentation talks briefly about Prevention trials, Screening trials, Treatment trials, Feasibility studies, Pilot studies, Phases in clinical trial, Multi-arm multi-stage (MAMS) trials, Global Clinical Trials, Vaccine efficacy, Vaccine safety, Emergency Use Authorization (EUA), Serious Adverse Events (SAE), SEA rules, The Vaccine Adverse Event Reporting System (VAERS), Vaccine Safety Datalink (VSD), The Advisory Committee on Immunization Practices (ACIP), Clinical Immunization Safety Assessment (CISA), CDSCO Rules Governing Clinical Trials, Schedule Y, The Ethics Committee, Empowered Committee on Animal Health, Tracking Vaccine Quality, Pre-clinical and Clinical data, Proof of Concept, Biological License Application (BLA) and Clinical hold.
Detection and Characterization of Pathotypes, Serotypes, Biotypes, Phenotypes...Bhoj Raj Singh
This presentation of my lecture, to Epidemiology students, briefs about different methods for differentiating or finding similarities among isolates of pathogens required establishing causal associations in epidemiological disease diagnosis.
Epidemiology of antigenic, genetic and biological diversity amongst pathogens...Bhoj Raj Singh
This presentation briefly describes the Antigenic, genetic and biological diversity amongst pathogens, and their origin and emergence. It also discusses with their association with different forms associated with a disease/ outbreak. The presentation also enlists diversity in strains causing some common diseases of livestock in India.
Differentiation of field isolates (wild) from vaccine strains (Marker, DIVA &...Bhoj Raj Singh
Nowadays vaccination is often reported as the cause of disease outbreaks. To ward off this misconception (vaccines are made to save the masses not to risk their lives)or to understand vaccination failures, it is necessary to understand the difference between a field strain causing the disease and a vaccine strain having attenuated virulence. This presentation talks about DIVA and DISA vaccines too.
Lumpy skin disease (LSD) Globally and in India.pptxBhoj Raj Singh
LSD has emerged as a dairy industry devastating disease in India in the last four years. First noticed in Orrisa and is now present all over India. Recurring outbreaks are now noticed in Rajasthan, Uttarakhand and other states indicating that the disease is becoming endemic in India.
Molecular determinants of pathogenicity and virulence among pathogens.pptxBhoj Raj Singh
The presentation discusses the pathogenicity and virulence of pathogens, their determinants and their interaction with the host. It talks briefly about pathogenicity, virulence, adhesions, invasions, toxins, disease, pathogenesis, pathogenicity islands (PAIs), intracellular, extracellular, bacteria, virus, fungi, prion, metazoan worms, protozoa, tuberculosis, E. coli, Salmonella, Yersinia, Mycobacterium, cytotoxins, enterotoxins, exotoxins, neurotoxins, endotoxins, in-silico, in-Vitro, in-vivo, immunohistology, haemagglutinins, spike proteins, integrins, and phagolysosomes.
Molecular epidemiology and Disease causation.pptxBhoj Raj Singh
This short presentation describes molecular epidemiology, differentiate it from genetic epidemiology, and also deals with ascertaining the cause of disease.
My research proposals, to porotect holy cow, rejected by the ICAR-IVRI in the...Bhoj Raj Singh
The presentation relates to my three research proposals, aimed at Protection of Holy cow, rejected at ICAR-ICAR-Indian Veterinary Research Institute, Izatnagar-243 122, India, in last five years
Clinical evaluation of newly advocated therapies for brucellosis in cattle and buffaloes. Duration: September 2019 to August 2021
A cross-sectional survey of Holy Cow Infectious Problems in Gaushalas (Gaushalas are protective shelters for stray cows in India). Duration: September 2022-August 2024
Explorative study on Epidemiological determinants associated with a drastic reduction in Milk Production of Dairy Animals with reference to communicable diseases. Duration: September 2022-August 2024
Animal Disease Control and Antimicrobial Resistance-A Message to Veterinary S...Bhoj Raj Singh
This presentation is for
• Introspection by all authorities before criticizing Veterinarians for an increase in AMR & to Doyens of Veterinary Science sitting mum when Vets are criticized!
• To realize that DAHD and State Animal/ Livestock Departments are:
– Fake data masters!
A realization to Doyens of Veterinary Science that they are:
– Spineless when their voice is the most needed!
– Don’t understand epidemiology to the least and make minimal attempts to improve Epidemiological understanding in veterinarians!
– The real negative thinkers!
– Suffering from an inferiority complex!
– Real killers of the holy cow!
– Interested to develop the best vet doctors but creating butchers!
– Real anti-nationals!
They talk of one health without understanding it!
– Much more!!!
Causes of Disease and Preserving Health in Different systems of Medicine.pptxBhoj Raj Singh
This presentation deals with concepts of disease causation and methods used for the alleviation of those causes to ensure health. It has briefed the causes of diseases according to Ayurvedic medicine, Unani medicine, Siddham medicine, Naturopathy, Homeopathy, Chinese medicine, Touch therapy- Reiki, Mantra therapy, and Allopathy. It also summarizes the treatments and practices in different systems of medicine. DOI: 10.13140/RG.2.2.30883.22569
AMR challenges in human from animal foods- Facts and Myths.pptxBhoj Raj Singh
This presentation talks about ÄMR: A public health threat, a “silent pandemic”.
Infections caused by Antimicrobial-drug-resistant (AMR) pathogens caused >1.27 million deaths worldwide in 2019 (low level or no surveillance) and increasing year after year which may be > million in coming decades. Covid-19 caused ~6.8 million deaths in >3 years but now the pandemic is ending but the AMR pandemic has no timeline for its ending. Many deaths are also attributed to AMR pathogens.
More antibiotic use (irrespective of the sector) = More AMR.
This presentation also talks about ways and means to mitigate the AMR pandemic. 1. Stopping the blame game. All are equally responsible for the emergence of AMR, the share of developed and educated communities is much more than poor and un-educated communities.
2. Working together: On-Line Real-Time AST Data Sharing Platform for different diagnostic and research laboratories doing AST routinely.
3. Implementing not only antibiotic veterinary and medical stewardship but antimicrobial production and distribution stewardship too.
4. Educating for Environmental health not only human, plant, and animal health.
5. AMR's solution is not in searching for alternatives to antibiotics but in establishing environmental harmony.
6. More emphasis on AMR epidemiology than on AMR microbiology and pharmacology.
7. Development of understanding that bacteria and other microbes are more essential for life on earth than the human race. Microbes can live without humans, but humans can’t without microbes.
Global-Health is of prime importance than economic growth/ greediness.
Herbal antimicrobials are considered as an important alternative to antibiotic and probable tools to mitigate emerging antimicrobial-drug-resistance (AMR). However, it is difficult to accept that microbes may not adapt to herbal antimicrobials as rapidly as to antibiotics. This is now well documented that herbal antimicrobial resistance is also common among common pathogenic microbes and genes are now known to encode herbal drug-resistance too. This lecture gives description how resistance to conventional antimicrobials impacts susceptibility of microbes for herbal antimicrobials. Lecture Scheduled on 21st February 2023, In: Antimicrobial Resistance (AMR) in Foodborne pathogens” sponsored under the ICAR-NAHEP-CAAST project by the MAFSU, Mumbai Veterinary College, at the Division of Veterinary Public Health, ICAR-IVRI from 20th February to 25th February, 2023.
Epidemiological characterisation of Burkholderia cepacia complex (Bcc) from c...Bhoj Raj Singh
The presentation is extracted from the thesis talking about
1. The presence of Bcc organisms in the clinical infections of animals.
2. Ultrasound gels as a potential source of pathogens, especially Bcc.
3. Multidrug resistance in BCCs.
4. Lack of regulatory guidelines in Indian Pharmacopeia as existing in USP.
There are hundreds of diseases of livestock and pet animals that can be printed through properly used quality vaccines. This presentation summarises different types of vaccines used by veterinarians to control/ prevent diseases. The presentation enlists the vaccine-preventable diseases of pets and livestock, and also the different vaccines used.
Major flaws in Animal Disease Control Leading to Partial Success or Failure.pptxBhoj Raj Singh
This presentation summarises major problems of Animal Disease Control Programs ongoing in India. India is a hyperendemic country for many animal diseases and zoonotic diseases. Every year billions of rupees are spent on disease control, surveillance, monitoring, and vaccination against vaccine-preventable diseases. However, due to the failure of most animal disease control programs for one or other reasons India directly losses about 20 and 25 thousand crores annually due to endemicity of FMD & brucellosis, respectively. The presentation identifies problems at different levels of different ongoing disease control programs in India. The non-availability of authentic disease data and flaws in vaccine quality control are the biggest problems.
Animal Disease Control Programs in India.pptBhoj Raj Singh
India is a hyperendemic country for many animal diseases and zoonotic diseases. Every year billions of rupees are spent on disease control, surveillance, monitoring, and vaccination against vaccine-preventable diseases. However, due to the failure of most animal disease control programs for one or other reasons India directly losses about 20 and 25 thousand crores annually due to endemicity of FMD & brucellosis, respectively. The presentation describes the pros and cons of different ongoing disease control programs going on in India.
Control and Eradication of Animal diseases.pptxBhoj Raj Singh
The presentation details different methods and terminologies used in disease management. It briefs about different types of disease control programs run at global, regional, and national levels. It also tells about the success and failure of different disease control programs. The presentation also briefed about methods of disease control.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Sample collection for bacterial isolation, characterization and antibiotic sensitivity testing
1. Sample collection for bacterial
isolation, characterization and ABST
BR Singh
Act. Head of Division of Epidemiology
ICAR-Indian Veterinary Research Institute, Izatnagar-243122, India
2. Errors in Sample collection for Bacterial
culture in Veterinary Clinics
• Collection of samples from poorly accessible sites
• Contamination of sample with normal
(commensal or indigenous) flora
• Failure to consider diversity of microbial agent(s)
of the disease.
• Temptation for the ease as collecting samples
• Errors in tentative diagnosis and need of
investigation.
• Lack of clinical history.
• Improper timing for sample collection.
3. What needs to be observed first when you order
a bacterial culture?
• Clinical observations suggesting infection
• Blood tests including:
– Total white blood cells and differential leucocytes’ counts.
– C-reactive protein (CRP) assay: Reading is >50 in serious
bacterial infections.
– Procalcitonin: It is a marker of generalised sepsis.
– Serology.
– Observation of any bacilli in blood smear.
• Routine urine examination: In UTI increase in pus cells.
• In Mastitis cases, slide tests for subclinical mastitis.
• For faecal samples, low grade fever, straining and stomach
cramps and or loose stool for long duration.
4. Collection of blood for culture
• At high fever stage.
• Multiple blood samples (2-3)
• From different veins.
• Local disinfection.
• In vacutainer or directly in to growth medium.
• Store and transport on ice or at 4-8oC.
5. How to sample a wound?
• Local disinfection (topical).
• Preferable sample may be fluid, cells or tissue.
• Samples should always be in duplicate.
• One for aerobic and another for anaerobic
culture.
• A sterile swab may be used to collect cells
or exudates (pus) from a superficial wound.
• From deeper wounds, aspirations of fluid into a
syringe and/or a tissue biopsy are the optimal
specimens for the recovery of pathogen.
6. Sampling for anaerobes
• Look for the clue of anaerobic infection
• Anaerobic bacteria are frequent after surgery , trauma, piercing nail
wounds.
• After prolonged antimicrobial therapy viz., aminoglycoside or broad
spectrum antimicrobial therapy and or lack of aerobic bacterial
growth.
• From wounds you may require puncturing by sterile needle and
aspirating exudates in syringe.
• To avoid oxygen to gain access to the samples or collecting sample
in vacutainer.
• Rapidly transport the sample for successful recovery of anaerobes,
and
• Special transport methods for samples packed in anaerobic-gas
packs may be desirable for detection of anaerobic bacteria.
7. Sampling from abscess
• Topical disinfection
• Drain out all the pus
• Insert a dry swab to rub on pus-forming
membrane with a few flakes of tissues and
blood.
• Swab can be transported to lab on ice or
within two hrs at ambient temperature in
sterile vials
8. Skin and mucosal samples for
bacterial culture
• A topical cleansing of the sampling area may often be
necessary .
• Dry sterile cotton-tip swab is rubbed on the suspicious skin
site, e.g., blistered or dry skin lesions or pustules, so that
something must come out of the suspected lesion.
• Moist swab are used for taking samples from mucosal
surfaces
• For collecting samples from natural orifices all care should
be taken to avoid the contact with the external openings
and for animals suitable specula can be used.
• Aspirates of fluid/pus oozing from a skin lesion using a
needle and syringe may be used.
• Skin biopsy, a small sample of skin removed under local
anaesthesia are also some times a desirable sample
9. Faecal/ Stool samples for bacterial culture
• Specify the suspected pathogen while ordering or
collecting sample for culture.
• While collecting stool samples be sure to wear
protective gloves and wash your hands afterward.
• Never collect Faecal samples from ground or
contaminated with urine
• Better to collect directly from rectum
• Use rectal swabs for small animals.
• The faecal sample should be placed into sterile clean,
dry plastic jars with screw-cap lids may be transported
on ice and you may be required to submit multiple
samples from a patient.
10. Urine samples
• Collection of urine sample for culture is not simple in
most of the cases as you cannot instruct animals to
retract their labia or prepuce to avoid contaminants
from commensal bacteria.
• The best way to collect sample is through urinary
catheter.
• Before inserting catheter local cleansing and
disinfection is desirable.
• The sample should be collected in sterile sample bottle
and transported as soon as possible to the laboratory.
• If long transport time is expected, transport on.
11. Cervical, vaginal and uterine samples
• Uterine samples can be collected either during post-
parturient infections, abortions or during oestrous when
cervix is open.
• Sheathed syringes or sheathed swabs can be used to collect
fluid or exudates present in uterus.
• Specula may be used for easier sampling.
• For deep vaginal and cervical samples, swabs are often
preferred.
• Collect samples using long handled swabs keeping vaginal
labia wide apart.
• Care should be taken to avoid any contact of swab with
clitoral region and urethral opening.
• Samples/ swabs should be transported in screw capped
containers either on ice or within two hours.
12. Collection of Samples from biopsy/
necropsy cases for culture
• Collect tissues/ exudates/ blood from heart as early as possible
after death of animal.
• Representative tissue/sample should be collected.
• For each sample separate sharp and sterile knife should be used for
cutting pieces from the most common predilection sites for the
suspected pathogen.
• Hollow organs should be swabbed with sterile cotton swabs,
preferably dry swabs.
• Hard organs like liver, kidneys etc. should be incised and sterile
swab should be inserted in to incision to soak the tissue sap.
• Samples should be sent on ice as soon as possible in sterile well
protected containers covered with non-porous wrappings.
• Proper labelling of the bottle/specimen samples is very essential.
13. Transport of samples for bacteriological
culture• A challenge
• All the samples should be sent in the growth arresting conditions below 4oC but the
samples should not be frozen.
• Packing should be into a non-porous packaging padded with absorbent cotton or tissues.
• Swab samples can also be transported at room temperature in semisolid (gel) transport
media
• Common transport media are:
– Carry and Blair transport medium, suitable for faecal swabs;
– For fastidious and more sensitive pathogens from blood, nasal swabs, or from tissues Amies
transport medium with Charcoal;
– For fastidious organisms and anaerobes thioglycollate medium is more suitable;
– For samples suspected for yeasts Chlamydospore medium is preferred;
– For more fastidious and slow growing pathogens (Neisseria, Streptococcus equi) swabs may be
transported in Stuart medium.
– For some of the pathogens more specific medium are preferred for transport of samples on
room temperature, viz., Listeria (Listeria isolation medium), Mycobacterium (Middlebrook 7H9
broth).
– For blood culture one can directly collect sample in liquoid broth, but it is not easily available.
• If nothing is available with you, you may also send samples in sterile normal saline having
25-30% glycerine.
14. Why do we test antimicrobial
susceptibility?
• To predict whether an infection will respond
to treatment with that antibiotic or not.
• To direct & predict antimicrobial chemotherapy.
• To review & monitor epidemiological trends.
• To set national & local antibiotic policies.
• To test the activity of a new antimicrobial agent.
• To presumptively identify isolates.
15. Components of Antibiotic Sensitivity
Testing
• 1.The identification of relevant pathogens in exudates
and body fluids collected from patients
• 2. Sensitivity tests done to determine the degree of
sensitivity or resistance of pathogens isolated from
patient to an appropriate range of antimicrobial drugs
• 3. Assay of the concentration of an administered drug in
the blood or body fluid of patient required to control the
schedule of dosage.
15
16.
17.
18. Methods for antimicrobial susceptibility testing
– Direct method
• Pathological specimen
• Sensitivity result – obtained in 24 hrs.
• e.g. urine, a positive blood culture, or a swab of pus
– Indirect method
• cultured plate from pure culture
• Results after 48 hrs or more
19. How do we perform antimicrobial
susceptibility tests?
• We can use a number of methods including:-
• Disc diffusion tests - Kirby-Bauer
- Stokes’
- BSAC.
• Dilution methods: - Tube or Agar dilution
• Agar Breakpoint method
• Minimum Inhibitory Concentration (MIC) – Tube MIC
or E-tests.
• Automated methods – Vitek.
• Molecular methods – PCR.
24. Disc diffusion method
The Kirby-Bauer test
• Developed in the USA in 1966.
• Based on NCCLS data.
• Use Mueller-Hinton agar.
• Use standard 0.5 McFarland (BaSO4)
inoculum.
• Streak inoculum in 3 directions or rotary plate.
25. Disc diffusion method : The Kirby-Bauer test……
• Use standard antibiotic-impregnated filter disc &
incubation conditions.
– 1949: Bondi and colleagues paper disks
– 1966: Kirby, Bauer, Sherris, and Tuck filter paper disks
• Demonstrated that the qualitative results of filter disk diffusion
assay correlated well with quantitative results from MIC tests
• Use standard NCCLS tables to interpret zone sizes as S, I or
R.
• Interpretation based on regression line analysis of zone
diameter size to MIC.
• Interpretation based on confluent growth of the organism.
26. Disc diffusion method : The Kirby-Bauer test…..
• Procedure (Modified Kirby-Bauer method: National Committee
for Clinical Laboratory Standards. NCCLS)
– Prepare approximately 108 CFU/ml bacterial inoculum in
a saline or tryptic soy broth tube (TSB) or Mueller-
Hinton broth (5 ml)
• Pick 3-5 isolated colonies from plate
• Adjust the turbidity to the same as the
McFarland No. 0.5 standard.
– Streak the swab on the surface of the Mueller-Hinton
agar (3 times in 3 quadrants)
– Leave 5-10 min to dry the surface of agar
27. Disc Diffusion Method…..
Invert the plates and
incubate them at 35 oC,
o/n (18-24 h)
Measure the
diameters of
inhibition zone in mm
27
28. Factors Affecting Size of Zone of Inhibition
• Inoculum density
• Timing of disc application
• Temperature of incubation
• Incubation time
Larger zones with light inoculum and
vice versa
If after application of disc, the plate
is kept for longer time at room
temperature, small zones may form
Larger zones are seen with
temperatures < 35 oC
Ideal 16-18 hours; less time does not
give reliable results
29. Factors Affecting Size of Zone of Inhibition
Size of the plate
Depth of the agar
medium (4 mm)
Proper spacing of
the discs (2.5 cm)
Smaller plates
accommodate less number
of discs
Thin media yield excessively
large inhibition zones and
vice versa
Avoids overlapping of zones
30. Factors Affecting Size of Zone of Inhibition
Potency of antibiotic
discs
Composition of medium
Acidic pH of medium
Alkaline pH of medium
Reading of zones
Deterioration in contents leads to
reduced size
Affects rate of growth, diffusion of
antibiotics and activity of
antibiotics
Tetracycline, novobiocin,
methicillin zones are larger
Aminoglycosides, erythromycin
zones are larger
Subjective errors in determining
the clear edge
31. Stokes’ Comparative Method
• Developed in the U.K (1972).
• A variety of media can be used including Iso-
sensitest agar (ISA), ISA & 5% lysed blood &
Chocolate ISA.
• Based on dense not confluent growth.
• Use suspension of organism in broth
equivalent in density to an overnight broth
culture.
• Inoculate fastidious organisms direct.
33. Vitek I
• The Vitek I was originally designed by NASA
for use as an on-board space exploration test
system.
• It is based on the use of small thin plastic
cards each containing many wells linked by
capillaries.
• These cards are available as susceptibility &
identification cards.
34. Molecular Methods
• Application of genotypic methods can allow rapid
detection of resistance genes direct from the sample.
• Examples include:-
• mecA gene detection by PCR denotes resistance to
methicillin in Staph aureus (MRSA).
• Rifampicin & isoniazid resistance in MDR
Mycobacterium tuberculosis can be detected using a
DNA probe.
• Antiviral drug resistance due to genetic point
mutations can be examined by PCR for HIV, CMV &
HCV.
35. Rapid tests of ABST
►Chromogenic Tests
• β lactamase enzyme- Haemophilus, Staph.
• Chloramphenicol resistance in Haemophilus
►Automated systems using new technologies
• Fluorescent methods
• Laser imaging
►Results available with MIC in 6 hrs.
►Very useful in guiding therapy.