This document provides guidelines for the treatment of nosocomial catheter-associated urinary tract infections (NCUTI) and urosepsis. It discusses the microbiological causes, risk factors, evaluation, diagnosis and treatment recommendations. The most common causative organism is E. coli. Risk factors include advanced age, diabetes, immunosuppression and indwelling catheters. Treatment involves supportive care and targeted antibiotic therapy based on culture and sensitivity results, with durations typically between 14-21 days. Catheter removal is also recommended when possible prior to antibiotic treatment.
approach to urosepsis/sepsis/septic shock.
general approach to sepsis, severe sepsis, septic shock according to the latest guidelines. SCG2016/ EGDT2018/EUA2020
Dr Ho Siew Hong shared his experience on how to perform the ideal puncture for PCNL in a lecture to Asian urologists during the Advanced Urology Course 2008 in Singapore
approach to urosepsis/sepsis/septic shock.
general approach to sepsis, severe sepsis, septic shock according to the latest guidelines. SCG2016/ EGDT2018/EUA2020
Dr Ho Siew Hong shared his experience on how to perform the ideal puncture for PCNL in a lecture to Asian urologists during the Advanced Urology Course 2008 in Singapore
Urinary tract consists of kidneys, ureters, urinary bladder and the urethra.
Infection most commonly involves the lower urinary tract which includes the bladder (cystitis) and urethra (urethritis).
UTI (Urinary Tract Infection) typically is caused by bacteria entering the bladder through the urethra. E.coli (Escherichia coli) is the most common bacteria responsible for UTI
To get relevant relevant details, Check out doctors article --> https://www.icliniq.com/articles/kidney-and-urologic-diseases/urinary-tract-infection-a-brief-overview
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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!
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
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
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. INTRODUCTION
• NCUTI among the most prevalent NCI
• Nosocomial bacteriuria develops in up to 25% of
patients requiring a urinary catheter for > 7 days
• The prevalence of hospital-acquired UTIs in the PEP
study was 10% and urosepsis accounted for 12% of all
episodes.
4. MICROBIOLOGICAL DATA
• Gram-negative bacilli E.COLI account for majority of the cases
while Gram-positive organisms are involved less frequently
,
• with E. coli being the commonest bacterium isolated in both
catheterized and non-catheterized patients
• Organisms isolated from patients with complicated urinary
infection and urosepsis tend to be more resistant
6. RISK FACTORS Of NCUTI
elderly patients
diabetics
immuno-suppressed patients.
Structural and functional abnormalities of the genitourinary tract
Indwelling urinary catheters
7. Classification of UTI
UncomplicatedUTI >>>healthy
individual
Complicated UTI >>> functional or
strucutional u t abnormality
Urosepsis
Special male genitourinary tract
infection eg epidedymitis
8. EVALUATION
• History is crucial in the evaluation of any UTI It
should include
any previous history of infections,
antibiotic use,
timeline of symptoms. If possible,
any laboratory results associated with previous
infections, including culture results should be
obtained.
9. • The physician should promptly look for evidence
of sepsis in sever form of UTI
• A thorough physical examination (including a
pelvic examination and digital rectal
examination to exclude acute prostatitis) should
also be performed.
10. INVISTIGATION
URINE FOR dipstick , R/E&CULTURE IS
CRUCIAL
ROUTINE BLOOD TEST +CRP
BLOOD CUTURE
LOCALIZING UNDERLYING URINARY TRACT
ABNORMALITY ULTRA SOUND CT&MRI
Urine sample should be taken from sample port not from drainage bag
urine should be transported to lab &processed within 10minute
presence or high acount of pyuria not indicate diagnosis if culture shows less than
10 3 cfu/ml
gram stain of centrifuged urine is reliable in detection of infected
organism
11. Diagnosis
• CA-UTI in patients with indwelling urethral,
indwelling suprapubic, or intermittent
catheterization is defined by
– the presence of symptoms or signs compatible with UTI
– no other identified source of infection
– >103
colony forming units (cfu)/mL of 1 bacterial species
in a single catheter urine specimen or in a midstream
voided urine specimen from a patient whose urethral,
suprapubic, or condom catheter has been removed
within the previous 48 h
12. Diagnosis
• CA-ASB in patients with indwelling urethral,
indwelling suprapubic, or intermittent
catheterization is defined
– >105
cfu/mL of 1 bacterial species in a single catheter urine
specimen
– patient without symptoms compatible with UTI
• CA-ASB in a man with a condom catheter is
defined
– >105
cfu/mL of 1 bacterial species in a single urine
specimen from a freshly applied condom catheter
– patient without symptoms compatible with UTI
13. Diagnosis
• In the catheterized patient, pyuria is not
diagnostic of CA-bacteriuria or CA-UTI
– The presence, absence, or degree of pyuria should
not be used to differentiate CA-ASB from CA-UTI
– Pyuria accompanying CA-ASB should not be
interpreted as an indication for antimicrobial
treatment
14. TREATMENT
GENERALSUPPORTIVE MANAGEMENT
• ANTIMICROBIAL THERAPY Antimicrobial Selection should
be depend on:
.Local(hospital /ward) pattern of microorganism isolation and
antibiotic resistance
Wherever possible, antimicrobial therapy should be delayed
pending results of urine culture and organism susceptibility,
unless sever form or impeding sepsis indicated empirical
regimes.
Where empirical therapy is initiated, the antimicrobial choice
should be reassessed once culture results become available,
usually within 48 h to 72hr
15.
16. Antibiotic regime for NCUTI
Urinary tract infections Possible antibiotic
uncomplicated cystitis- Nitrofurntion 100mg orally for 3days
Bactrim DS orally twice daily for 3 day
Ciprofloxacin 250mg orally twice daily for 3 days
or Levofloxacin 250mg orally once daily for 3 days
or augamantine
uncomplicatepyelonephritisI
complicated cystitis or
pyelonephritisl
,Ciprofloxacin 200-400mg IV every 12 hour orLevofloxacin
250 to 500mg IV once
or aminoglycosideas 2line amikacinor gentamicin,
intravenous regimen such as a fluoroquinolone, amino
glycoside (with or without an extended-spectrum
cephalosporin, an extended-spectrum penicillin, or a
carbapenem for7-14d
17. hospital-acquired urosepsis
regime Dose
antipseudomonal third-generation
cephalosporin
cefepime,
ceftazidime
1–2g every 8–12 h
2g every 8 h
Or piperacillin/beta- lactamase inhibitor
imipenem or meropenem(tazocine(
or carbamide merepnem
.4 5g every 6 h
500mg every 6 h
plus
aminoglycoside (amikacin,
(gentamicin
ا
7mg/kg per d†
Amikacin 20 mg/kg per dt
18. community-acquired primary urosepsis
regime dose
Or
3rd
generation cephalosporin eg:Ceftriaxone 1to2g daily
+pipracillin
)beta-l actamase inhibitor (tazocin
.4 5g every 6 h
or
afluoroquinolone
levofloxcine,ciproflaxcine
750mg every d
400mg every 8 h
A combination therapy with an aminoglycoside or a carbapenem may
be essential in areas with high rate of fluoroquinolone resistance.
19. IMPORTANT NOTES
Most patients require treatment for about 14-21 days
Successful antimicrobial therapy will usually ameliorate
symptoms promptly,
Patients who fail to respond in this time frame should be
reassessed to exclude
urinary obstruction or abscess (which may require
drainage),
to exclude resistance of the infecting organism
consider an alternate diagnosis
Catheters should be replaced before initiating
antimicrobial therapy for the treatment of a symptomatic
20. REFRENCES
•Nottingham Antimicrobial Guidelines Committee April 2011 Review April 2012
•European Prevalence of Infection in Intensive care Study. EPIC International Advisory Committee
•European Society of Infections in Urology. Hospital acquired urinary tract infections in and use of
antibiotics. Data from the PEP and PEAP-studies.
•SENTRY Antimicrobial Surveillance Program (2000 Diagn Microbiol Infect((.
•The European and Asian guidelines on management and prevention of catheter- urinary tract
infections associated
•Surviving Sepsis Guidelines
•TMC infectious control
22. always consider local pattren
of microrganisms resistence
,avilblity of antibiotic ,host factor
always consider delyed anti biotic
as much as patient clinical satuation
tolarate to direct antibiotic according
to result of culture& sensitvity