Driven AND STRATEGIC PLANNING IN SOUTH AFRICA .


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Presentation: Development of LED Strategies in SAStrategic Planning in SA:Integrated Development PlanningLED PlanningImportance of LED PlanningChallenges of LED PlanningSalga concentrate on advancing successful LED arranging. Substance. A past filled with solid incorporated arranging and politically-sanctioned racial segregation spatial advancement strategies = practically no LED preceding the 1996 nearby government electionsHeralding in of another loc
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Slide 1

Skyline Scanning in Microbiology Diagnostics Dr Jaisi Sinha Consultant Microbiologist and Virologist NPHS Microbiology, Cardiff

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Outline of this Presentation What are the conventional and more up to date indicative strategies in microbiology? What is the part of atomic testing in microbiology? How would we apply these advances to affect on patient administration?

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A Microbiologist\'s View Clinical Support and Advice Laboratory Diagnosis of disease Patient Management New or safe contaminations Antimicrobial specialists Outbreak administration

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Laboratory Diagnosis of Infection – Test choice Selection of an analytic test Specimen, detach Speed, specificity affectability Application, importance Is new truly better?

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What are the conventional and more up to date symptomatic techniques in microbiology? What is the Role of Molecular testing in Microbiology? How would we apply these innovations to affect on patient administration?

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Traditional and more current strategies for conclusion in microbiology Microscopy and culture Identification – phenotypic Antimicrobial weakness – phenotypic Newer phenotypic based tests Since HIV-extension in new atomic testing in virological diagnostics

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Advantages of conventional techniques Can be catch-all and analyze blended contaminations Established affectability and techniques Living life forms can be recuperated

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Disadvantages of customary techniques Labor-serious Therefore likewise saw as costly and moderate A "gifted" movement – administrator subordinate Results might not have a distinct recognizable proof

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Molecular symptomatic tests - fundamental ideas of nucleic corrosive based tests The principle reason for enhancement (e.g. PCR) is to make a colossal number of duplicates of a quality. Does not require suitable life forms Can be exceptionally delicate – yet tainting issues For rate requires a known target quality arrangement Therefore can miss questions Molecular testing in analytic microbiology is generally confined to identification (subjective), measurement (viral load), and genotyping. Not as a rule sequencing Ability to distinguish obscure or various living beings slower - may take days or weeks and require reference/explore lab offices

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What are the conventional and more up to date indicative strategies in microbiology? What is the part of sub-atomic testing in microbiology How would we apply these innovations to affect on patient administration?

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What is the Role of Molecular testing in Microbiology Discovery of new contaminations at a reference research facility level Established clinical application for administration of certain virology diseases Its part somewhere else in microbiology?

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What is the Role of Molecular testing in Microbiology Discovery of new diseases at a reference lab level

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Diagnosis of New and Emerging contaminations How is it done in an authority reference research facility? Electron microscopy/immunofluorescence/culture Obtain a "guilty party" living being, representation Extraction, intensification and discovery of DNA/RNA succession – requires expansive range PCR as particular target arrangement obscure Cloning of grouping – filtration of PCR item Sequencing – set up likely obscure target arrangement, plan PCR test, phylogenetics Proteomics – distinguish destructiveness components, phylogenetics, neutralizer outline ELISA plan – serological measures

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What is the Role of Molecular testing in Microbiology Established clinical application for administration of certain virology diseases

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Molecular Diagnostic Testing-Current Uses in Virology Routine viral location Replacing cell culture – delicate, fast BBVs, Intrauterine contaminations, respiratory infections, norovirus Viral Load Monitoring (treatment checking) – HIV, HCV, CMV (pre-emptive observing) Genotyping/resistance testing – HIV, HBV, HCV

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What is the Role of Molecular testing in Microbiology Its part somewhere else in microbiology?

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Other at present accessible indicative sub-atomic tests Fastidious microbes – C. trachomatis , GC, pertussis, TB, M. genitalium , T. whipplei, C. burnetti, B. henselae Rapid Bacterial analysis – N. meningitidis, S. pneumoniae, H. influenzae Antibiotic resistance – MRSA, VRE, ESBL, multi-tranquilize safe TB Parasites/Fungi – T. gondii, Malaria, P. carinii, Aspergillus

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Current symptomatic sub-atomic tests-preferences Rapid analysis Non-culturable, or moderate developing, picky living beings Antibiotic defenselessness Culture-negative examples Bacterial writing

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Current Molecular Diagnostic Tests - Disadvantages Rapid tests can distinguish particular life forms just Do not give a catch-all in a reasonable time period Can be exceptionally costly Significance of results or test applications not settled

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What are the customary and more up to date demonstrative strategies in microbiology? What is the Role of Molecular testing in Microbiology How would we apply these advancements to affect on patient administration?

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Diagnosis of Infection-a couple jumps in the "New" NHS Immunocompromised patients "New" or safe contaminations Pathology modernisation, clinical changes and Trust rebuilding Application of customary, present and new analytic tests

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Meningococcal PCR Well settled test Management of meningococcal meningitis - clinical finding Patient care – early (GP) treatment Public wellbeing – early prophylaxis Results of PCR test Negative – not v.sensitive: proceed early abx, prophylaxis Positive – affirms culture negative; serotyping and more extensive prophylaxis Application not in light of speed of test

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MRSA PCR Suggested as potential screening apparatus 4hr test; clump testing Sensitivity Cost Application of results Patient cohorting/disconnection

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Hain Strip for Blood societies New innovation Identification of particular microscopic organisms Specific anti-toxin affectability comes about Within 4 hours of a positive blood culture (12-48 hours) Rapid contrasted with conventional strategies BUT future effect on patients?

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Impact on patient care? Surviving sepsis battle: compelling anti-infection treatment advantage < 1 hours Less genuine contaminations: successful anti-microbials at 24 hours Where will Hain strip enhance customary strategies for patient result? How might we best apply our assets on enhancing quiet results in the NHS

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Microarrays in Blood Cultures what\'s to come? Microchips with more up to date nucleic corrosive intensification and discovery frameworks Enormous potential for catch-all Rapid recognizable proof, anti-infection helplessness, harmfulness components Self-contained instruments for close patient conclusion?

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Summary Currently culture techniques are still extremely compelling especially in non-viral diagnostics Molecular strategies can be quick for particular diseases Currently for blended contaminations or obscure diseases, immaculate atomic techniques not generally prevalent in a demonstrative research center What in the event that we lose conventional strategies all the while? What affect does the new technique have on patient administration?

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\'Why does this grand connected science which spares work and makes life simpler bring us so little satisfaction? The straightforward answer runs: Because we have not yet figured out how to make sensible utilization of it.\' Address, California Institute of Technology (1931)

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