A Simple Guide to Menopause (Part 2)
----------------------------------------------
How to Treat the symptoms of Menopause?
----------------------------------------------------
In most cases of menopause, no treatment is necessary as it is a normal physiological event.
It is important that there is reassurance and psychological support from family and friends.
Menopause may mean the end of fertility but it also means the freedom from all the discomfort and inconvenience of monthly menstruation and fear of pregnancy.
Hormone replacement therapy used to be the best solution for all the symptoms and problems of menopause at one time.
They help to prevent heart disease and osteoporosis as well as to reduce the symptoms of menopause such as hot flushes, skin , breast and vaginal changes.
Oestrogen and progesterone are the two types of female hormones prescribed for and after menopause.
A combination of the two hormones is taken, as progesterone helps to protect the uterus from endometrial cancer.
If the woman have had removal of the womb, she will normally be given only oestrogen.
HRT can be taken as pills as a single oestogen tablet or as combination of oestrogen and progesterone.
Besides tablets, female hormonal patches, implants or vaginal creams can be used to help replace the level of hormones in the menopausal women.
There are benefits to the use of HRT:
1.Relieves hot flushes
2.reduce vaginal dryness.
3.Prevents osteoporosis and protects against fractures.
4.Indirectly improves mood symptoms by relieving the physical discomfort of menopause.
5.Safe for short term use.
There are also risks in using HRT:
1.increase risk for breast cancer for long term users (>5 years).
2.side effects such as vaginal bleeding, nausea, hair loss and headaches.
3.cause PMS (Pre-Menstrual Syndrome) symptoms such as bloating or irritability.
4.cause venous thrombosis due to increased coagulation of blood.
Hormone replacement therapy has recently fell out of favour due to new study which indicate higher incidence of breast and womb cancer taking HRT over a 5 year period.
It is still prescribed more as a single oestrogen tablet rather than a combination pill of oestrogen and progesterone.
Selective estrogen receptor modulators(SERM) like Evista has been used to replace HRT with good effect.
Plant based female hormones has also being used to reduce the symptoms of menopause. Alternative medicines like evening primrose oil has also been used.
For premature menopause where symptoms of menopause are more obvious due to their age, hormone replacement therapy is still given at intervals of 6 to 12 months.
Besides hormonal therapy, medicines such as:
1200mg of calcium daily
800 to 1000 IU of vitamin D daily
may be able to help prevent osteoporosis.
The current treatment for the symptoms of menopuse in the older women are:
1. A healthy life style.
Exercise
Regular exercise strengthen the muscles and bone.
Exercise also burns up calories to reduce obesity and hence prevent diabetes, hypertension and heart disease.
Walking is one of the best weight-bearing exercises to prevent osteoporosis.
Swimming and dancing are also good exercises.
Eat a balanced diet
A good balanced diet helps to prevent obesity, diabetes, osteoporosis, heart disease and colorectal cancer.
More fruit and vegetables will help reduce calories and prevent colorectal cancer.
Foods rich in calcium and Vitamin D such as fish, low fat high calcium milk can prevent osteoporosis.
Alcohol, coffee, tea, canned drinks should be avoided.
Less sugar, salt and saturated fats will reduce the risk of diabetes,hypertension and heart disease.
Control Stress
Medititation, yoga, deep breathing exercises and sufficient sleep reduces stress and heart disease.
Community service work, hobbies, time with family take the mind off work and stress.
Stay smoke-free
The risk of heart disease, lung and cervical cancer can be reduced by not smoking.
2.hot flushes:
Cool showers and cool tempreatures may help to reduce hot flushes.
Hot beverages and spicy foods should be avoided.
Thin cotton clothes are more comfortable.
Drinking a glass of cold water, loosening any tight clothing and using a small fan to cool down can stop the beginning of a hot flush.
Soy products like tofu and soya bean burns up less calories.
Meditation and mild exercise may also help by reducing stress.
hormone replacement therapy (mainly oestrogen) for a short peroid may be used as a last resort.
3.vaginal changes
Water-soluble vaginal lubricants can reduce dryness.
Oestrogen replacement creams may be prescribed to reduce the vaginal discomfort.
4.incontinence:
Doing simple pelvic floor exercises will strengthen the muscles surrounding the sphincter of the bladder opening.
Wearing a pad in the underwear may reduce the discomfort due to leaks.
Injection of collagen sometimes work to tighten the sphincter of the bladder opening.
Surgery to tighten the muscles of the bladder opening may be used as a last resort.
5.mood changes:
Many women going through menopause may become irritable,anxious or depressed.
Learn how to relax and make time for yourself.
Exercise is good for your health as it keeps your mind off emotional problems!
A hobby or volunteer work that you enjoy may take your mind off your symptoms.
Build up a good support system through talking with friends or a professional counsellor.
6.Osteoporosis:
A balanced diet with adequate calcium and active lifestyle can prevent development of osteoporosis:
Women who are at higher risk are those who
had early menopause or have ovaries removed
have a family history of osteoporosis
have a diet low in calcium and Vitamin D
smoke
are not physically active
are on steroids for long term (E.g. asthmatics)
drink coffee, tea or alcohol regularly
have certain disease such as an overactive thyroid gland
7.Breast Cancer
It is the most common cancer in menpausal women in their 50s.
Early detection by doing monthly breast self examination and a mammography once a year in your 40s and once every two years after age 50 is the best prevention.
8.Cervical Cancer
Cervical cancer is another common cancer among women.
It can be prevented by going for regular Pap smear tests.
Pap smear tests for cervical cancer once every 3 years from age 25 to 65 years if sexually active.
Pap smears can detect precancer so that early treatment can prevent full blown cancer.
9.Regular check-ups
Early detection and checkup can prevent complications such as heart disease and stroke.
A yearly blood pressure with blood sugar and blood cholesterol once every 3 years help to check for danger of heart disease and stroke.
Stay active and be confident about the future.
Take care of your health and personal appearance so that you both look and feel good.
Menopause marks a new Chapter in your life
-----------------------------------------------------
While menopause marks the end of fertility, it is NOT the end of health, or a satisfying and enjoyable life. Menopause means freedom from the inconvenience and discomfort of monthly menses.
Every Woman Goes Through Menopause
Knowledge about menopause is important so that you know what to expect.
Most women welcome the cessation of periods.
Others may feel a sense of loss that their childbearing ability is gone.
By understanding the physical and emotional changes of menopause, more women are able to cope with life in the golden years.
Monday, December 3, 2007
Saturday, December 1, 2007
A Simple Guide to Menopause
A Simple Guide to Menopause(Part 1)
---------------------------------------------
What is Menopause?
-------------------------
Menopause is the cessation of menstruation occuring in women between the ages of 45 and 55 years.
It is important to stress that it is NOT an illness but a natural event.
The age that menopause occur may vary with different women.
What Causes Menopause?
--------------------------------
Natural Menopause
------------------------
From puberty a woman starts releasing eggs from their ovaries.
Both the ovaries and eggs produces female hormones.
These hormones thickens lining of the womb in preparation for a pregnancy.
If the pregnancy does not occur, the lining of the womb is shed off as blood and cells(menses).
As the woman grows older, less eggs are produced resulting in reduced production of the female hormones.
This causes the menstrual periods to be less or more than usual.
When no more eggs are produced, the amount of the hormones produced are not enough to cause the lining of the womb to thicken.
As a result menstruation will stop.
Menopause is said to be established when the woman does not have any menstruation for one year.
Premature Menopause
---------------------------
Premature menopause occurs when the menses stop in a woman before the age of 40 yrs.
The causes of premature menopause are
1.surgery to remove the womb or ovaries in the case of cancer,
2. chemotherapy and
3. radiotherapy.
Without the protective effect of oestrogen, these young women will have a higher chance of having osteoporosis and heart disease later in life .
Women who smokes usually have menopause 2 years earlier than non-smokers.
What are the symptoms and signs in Menopause?
----------------------------------------------------------
Most women do not have any symptoms except for the loss of their monthly periods.
In others, the change in female hormones may cause the following symptoms:
1.Irregular menstrual patterns - usually the menses can become lighter or further apart.
One or two periods may be missed.
2.Hot flushes -sudden feeling of heat starting from the chest to the face.
There may be associated sweating, fast heart beats, fainting and insomnia.
The exact cause is not known and may be due to vasomotor disturbances related to the fluctuating hormone levels.
It usually improve after 1-2 years.
3.Vaginal tract changes - With menopause, the walls of the vagina become thinner, dryer because of less secretions, and more prone to infection.
Because ot these changes, sexual intercourse may be uncomfortable or painful.
3.Incontinence - With age and onset of menopause, the muscles around the bladder opening may weaken, leading to leakage of urine with straining or coughing (incontinence).
Muscles of pelvic floor loses tone with possible prolapse of uterus.
4.Breasts tissues may become atrophied with decrease in size of the nipples.
The breast may become more pendulous.
5.Skin may be less smooth and wrinkles may appear.
Hair may also become thinner and dryer.
6.Mood and memory: irritability, anxiety, depression, insomnia (difficulty in sleeping), poor concentration and poor memory may be due to the lowered female hormones or pyschological due to change in the body, skin and appearance.
What are complications of Menopause?
-----------------------------------------------
1.Osteoporosis:
The bones may become brittle, fragile and fracture easily after menopause because oestrogen is important in maintaining bone mass.
Hormone replacement may be able to reduce the bone loss and prevent osteoporosis.
2.Cancer:
Menopause itself does not cause an increased risk of women cancer.
It is rather the age group that they are in which may increase the risk of cancer.
3.Heart disease and stroke
After menopause, women are more likely to get hypertension or high blood cholesterol which increases the risk of a heart attack and stroke.
4.Metabolic disease
Again after menopause, some women tend to burn less energy and gain weight.
Decrease in metabolism leads to accumulation of sugars which can increase the risk of Diabetes
---------------------------------------------
What is Menopause?
-------------------------
Menopause is the cessation of menstruation occuring in women between the ages of 45 and 55 years.
It is important to stress that it is NOT an illness but a natural event.
The age that menopause occur may vary with different women.
What Causes Menopause?
--------------------------------
Natural Menopause
------------------------
From puberty a woman starts releasing eggs from their ovaries.
Both the ovaries and eggs produces female hormones.
These hormones thickens lining of the womb in preparation for a pregnancy.
If the pregnancy does not occur, the lining of the womb is shed off as blood and cells(menses).
As the woman grows older, less eggs are produced resulting in reduced production of the female hormones.
This causes the menstrual periods to be less or more than usual.
When no more eggs are produced, the amount of the hormones produced are not enough to cause the lining of the womb to thicken.
As a result menstruation will stop.
Menopause is said to be established when the woman does not have any menstruation for one year.
Premature Menopause
---------------------------
Premature menopause occurs when the menses stop in a woman before the age of 40 yrs.
The causes of premature menopause are
1.surgery to remove the womb or ovaries in the case of cancer,
2. chemotherapy and
3. radiotherapy.
Without the protective effect of oestrogen, these young women will have a higher chance of having osteoporosis and heart disease later in life .
Women who smokes usually have menopause 2 years earlier than non-smokers.
What are the symptoms and signs in Menopause?
----------------------------------------------------------
Most women do not have any symptoms except for the loss of their monthly periods.
In others, the change in female hormones may cause the following symptoms:
1.Irregular menstrual patterns - usually the menses can become lighter or further apart.
One or two periods may be missed.
2.Hot flushes -sudden feeling of heat starting from the chest to the face.
There may be associated sweating, fast heart beats, fainting and insomnia.
The exact cause is not known and may be due to vasomotor disturbances related to the fluctuating hormone levels.
It usually improve after 1-2 years.
3.Vaginal tract changes - With menopause, the walls of the vagina become thinner, dryer because of less secretions, and more prone to infection.
Because ot these changes, sexual intercourse may be uncomfortable or painful.
3.Incontinence - With age and onset of menopause, the muscles around the bladder opening may weaken, leading to leakage of urine with straining or coughing (incontinence).
Muscles of pelvic floor loses tone with possible prolapse of uterus.
4.Breasts tissues may become atrophied with decrease in size of the nipples.
The breast may become more pendulous.
5.Skin may be less smooth and wrinkles may appear.
Hair may also become thinner and dryer.
6.Mood and memory: irritability, anxiety, depression, insomnia (difficulty in sleeping), poor concentration and poor memory may be due to the lowered female hormones or pyschological due to change in the body, skin and appearance.
What are complications of Menopause?
-----------------------------------------------
1.Osteoporosis:
The bones may become brittle, fragile and fracture easily after menopause because oestrogen is important in maintaining bone mass.
Hormone replacement may be able to reduce the bone loss and prevent osteoporosis.
2.Cancer:
Menopause itself does not cause an increased risk of women cancer.
It is rather the age group that they are in which may increase the risk of cancer.
3.Heart disease and stroke
After menopause, women are more likely to get hypertension or high blood cholesterol which increases the risk of a heart attack and stroke.
4.Metabolic disease
Again after menopause, some women tend to burn less energy and gain weight.
Decrease in metabolism leads to accumulation of sugars which can increase the risk of Diabetes
Wednesday, November 28, 2007
A Simple Guide to Folliculitis
A Simple Guide to Folliculitis
-----------------------------------------
What is Folliculitis?
--------------------------
Folliculitis is an infection of the hair follicles.
What are the causes of Folliculitis?
-------------------------------------
Folliculitis may occur after:
1. abrasions or wounds on the skin
2.friction due to tight clothing
3.eczema or dermatitis
4.diabetes or leukemia patients are more susceptible to infection
The bacteria causing the folliculitis is usually staphylococcus aureus.
What are the symptoms and signs of Folliculitis?
---------------------------------------------
There is usually a superficial pustule or inflammatory nodule surrounding the base of a hair.
They may occur all around the same area or scattered on the body.
Chronic Folliculitis may occur around the beard area.(sycosis barbae)
What are the complications of Folliculitis?
-------------------------------------------
The inflammatory nodule of Folliculitis may develop into a pustule with cental necrosis and discharge of pus and sometimes blood stained material.
This is a furuncle or boil.
A group of furuncles can merge and become a larger entity called a carbuncle which is deep and wide .
What is the treatment of Folliculitis?
---------------------------------------
Most mild Folliculitis may disappear by itself without treatment after a few days.
The severe cases requires topical antibiotic creams like bactroban or systemic antibiotics to clear the infections.
Carbuncles may need surgical treatment.
-----------------------------------------
What is Folliculitis?
--------------------------
Folliculitis is an infection of the hair follicles.
What are the causes of Folliculitis?
-------------------------------------
Folliculitis may occur after:
1. abrasions or wounds on the skin
2.friction due to tight clothing
3.eczema or dermatitis
4.diabetes or leukemia patients are more susceptible to infection
The bacteria causing the folliculitis is usually staphylococcus aureus.
What are the symptoms and signs of Folliculitis?
---------------------------------------------
There is usually a superficial pustule or inflammatory nodule surrounding the base of a hair.
They may occur all around the same area or scattered on the body.
Chronic Folliculitis may occur around the beard area.(sycosis barbae)
What are the complications of Folliculitis?
-------------------------------------------
The inflammatory nodule of Folliculitis may develop into a pustule with cental necrosis and discharge of pus and sometimes blood stained material.
This is a furuncle or boil.
A group of furuncles can merge and become a larger entity called a carbuncle which is deep and wide .
What is the treatment of Folliculitis?
---------------------------------------
Most mild Folliculitis may disappear by itself without treatment after a few days.
The severe cases requires topical antibiotic creams like bactroban or systemic antibiotics to clear the infections.
Carbuncles may need surgical treatment.
Tuesday, November 27, 2007
A Simple guide to Whooping Cough
A Simple guide to Whooping Cough
------------------------------------
What is Whooping Cough?
-----------------------
Whooping cough is an acute infectious childhood disease of the respiratory tract caused by the bacillus Bordetella pertussis.
How is Whooping Cough transmitted?
---------------------------------
Whooping Cough is transmitted by droplets from coughing spells.
It is highly infectious.
The early stage when it appears to be a cold is the most infectious peroid.
Most infections occur in children under six years of age.
One attack usually confers immunity
What are the Signs and Symptoms of Whooping Cough?
---------------------------------------------------
The incubation peroid is usually 10 - 12 days after contact with an infected child.
Symptoms start off with:
1.an ordinary cold (runny nose, sneezing, cough, fever) for 1-2 weeks followed by:
2.uncontrolled coughing that can last 1 - 2 months.
Cough persists and become paroxysmal ending in a noisy inspiration "whoop" sound causing the child to go blue and vomit.
Between the spasms of coughing the child seems relatively well
What are the complications of Whooping Cough?
---------------------------------------------
The worst affected are children below the 1 year old.
Some serious complications are:
1.pneumonia,
2.seizures,
3.brain damage
4.nose bleeds
5.death can occur during the severe coughing stage.
Serious complications are less with older children or adults.
Adults rarely get whooping cough because their immmunity from vaccination usually last 10 years after the last dose.
When adults get whooping cough, a prolonged, irritating cough may be present instead of whooping type of cough.
What is the Treatment of Whooping Cough?
--------------------------------------------
Antibiotics (erythromycin) are used in the treatment of Whooping cough.
Once severe coughing has begun, antibiotics are less effective. They can reduce the duration of the illness and stop the spread to others.
Family members should be treated once there is an infected person.
Tetracycline is used if the patient is allergic to erythromycin but should avoided in children because of the staining of the teeth.
Besides antibiotics, the following will help:
1.Steam inhalation
2.cough mixtures
3.oxygen therapy
4.avoid smokes, dust, dry air,sudden temperature change
What is the Prevention for Whooping Cough?
-----------------------------------------
Vaccination against whooping cough is the best prevention .
Since vaccination began, the worldwide incidence of whooping cough has declined.
Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.
There is a booster vaccination at 18 months.
In very rare cases (1 in 100,000 cases), there has been serious reactions such as seizures to the whooping cough part of the vaccination.
Recently, an improved acellular pertussis vaccine is now available. There are fewer side effects such as high fever and seizureswith this new vaccine.
------------------------------------
What is Whooping Cough?
-----------------------
Whooping cough is an acute infectious childhood disease of the respiratory tract caused by the bacillus Bordetella pertussis.
How is Whooping Cough transmitted?
---------------------------------
Whooping Cough is transmitted by droplets from coughing spells.
It is highly infectious.
The early stage when it appears to be a cold is the most infectious peroid.
Most infections occur in children under six years of age.
One attack usually confers immunity
What are the Signs and Symptoms of Whooping Cough?
---------------------------------------------------
The incubation peroid is usually 10 - 12 days after contact with an infected child.
Symptoms start off with:
1.an ordinary cold (runny nose, sneezing, cough, fever) for 1-2 weeks followed by:
2.uncontrolled coughing that can last 1 - 2 months.
Cough persists and become paroxysmal ending in a noisy inspiration "whoop" sound causing the child to go blue and vomit.
Between the spasms of coughing the child seems relatively well
What are the complications of Whooping Cough?
---------------------------------------------
The worst affected are children below the 1 year old.
Some serious complications are:
1.pneumonia,
2.seizures,
3.brain damage
4.nose bleeds
5.death can occur during the severe coughing stage.
Serious complications are less with older children or adults.
Adults rarely get whooping cough because their immmunity from vaccination usually last 10 years after the last dose.
When adults get whooping cough, a prolonged, irritating cough may be present instead of whooping type of cough.
What is the Treatment of Whooping Cough?
--------------------------------------------
Antibiotics (erythromycin) are used in the treatment of Whooping cough.
Once severe coughing has begun, antibiotics are less effective. They can reduce the duration of the illness and stop the spread to others.
Family members should be treated once there is an infected person.
Tetracycline is used if the patient is allergic to erythromycin but should avoided in children because of the staining of the teeth.
Besides antibiotics, the following will help:
1.Steam inhalation
2.cough mixtures
3.oxygen therapy
4.avoid smokes, dust, dry air,sudden temperature change
What is the Prevention for Whooping Cough?
-----------------------------------------
Vaccination against whooping cough is the best prevention .
Since vaccination began, the worldwide incidence of whooping cough has declined.
Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.
There is a booster vaccination at 18 months.
In very rare cases (1 in 100,000 cases), there has been serious reactions such as seizures to the whooping cough part of the vaccination.
Recently, an improved acellular pertussis vaccine is now available. There are fewer side effects such as high fever and seizureswith this new vaccine.
Monday, November 26, 2007
A Simple Guide to Dysmenorrhea
A Simple Guide to Dysmenorrhea
----------------------------------------
What is Dysmenorrhea?
-----------------------------
Dysmenorrhea is a symptom, not an illness.
It means painful menstruation.
What are the types of Dysmenorrhea?
--------------------------------------------
Dysmenorrhea may be classified into:
1.Primary or Spasmodic Dysmenorrhea
2.Secondary Dysmenorrhea due to causes like
Endometriosis or
Pelvic Inflammatory Disease
What are the Causes of Dysmenorrhea?
----------------------------------------------
The cause of primary Dysmenorrhea is still not known.
There are a few theories:
1.during menstruation, contraction of the uterine muscles occurs in spasms trying to push the menstrual flow through a narrow cervical opening
2.Prostagladins output occurs at time of menstruation producing muscles spasms
3.Menstrual clots occludes the uterine opening and requires more contractions of the uterine muscles to push it through
4.Stress may constrict the opening of the uterus and hence greater contraction of the uterine muscles is required to force out the menstrual flow.
What are the Symptoms of Dysmenorrhea?
--------------------------------------------------
Primary Dysmenorrhea:
----------------------------
1.typically occurs on the first day of menses and becomes less after the 2nd day.
2.lower abdominal cramp radiating down to thighs and back
Secondary Dysmenorrhea:
-------------------------------
1. Starts about 1 week before menses and reach maximum on first day before reducing intensity for rest of menses peroid
2.dull aching pain in lower abdomen with radiation to the back
Symptoms may be associated with
1.vomiting,
2.urinary frequency,
3.headache,
4.painful breasts,
5.abdominal distension,
6.depression and
7.irritabilty.
What is the Treatment for Dysmenorrhea?
--------------------------------------------------
Primary Dysmenorrhea:
----------------------------
1.simple analgesics like paracetamol
2.Non-steroidal anti-infammatory drugs like Ponstan, Synflex
3.Antispasmodics
4.Tranquilliser or antidepressant
5.Muscle relaxant
6.female hormones
Secondary Dysmenorrhea:
-----------------------------------
1.Identify and treat the underlying cause(eg. antibiotics for PID)
2.Endometriosis may require a course of female hormones or surgery for control
3.Dilatation of the endocervical canal may help
What is the prognosis of Dysmenorrhea?
------------------------------------------------
Primary Dysmenorrhea may end with first pregnancy due to widening of uterine opening.
Secondary Dysmenorrhea prognosis depends on the treatment of causes.
----------------------------------------
What is Dysmenorrhea?
-----------------------------
Dysmenorrhea is a symptom, not an illness.
It means painful menstruation.
What are the types of Dysmenorrhea?
--------------------------------------------
Dysmenorrhea may be classified into:
1.Primary or Spasmodic Dysmenorrhea
2.Secondary Dysmenorrhea due to causes like
Endometriosis or
Pelvic Inflammatory Disease
What are the Causes of Dysmenorrhea?
----------------------------------------------
The cause of primary Dysmenorrhea is still not known.
There are a few theories:
1.during menstruation, contraction of the uterine muscles occurs in spasms trying to push the menstrual flow through a narrow cervical opening
2.Prostagladins output occurs at time of menstruation producing muscles spasms
3.Menstrual clots occludes the uterine opening and requires more contractions of the uterine muscles to push it through
4.Stress may constrict the opening of the uterus and hence greater contraction of the uterine muscles is required to force out the menstrual flow.
What are the Symptoms of Dysmenorrhea?
--------------------------------------------------
Primary Dysmenorrhea:
----------------------------
1.typically occurs on the first day of menses and becomes less after the 2nd day.
2.lower abdominal cramp radiating down to thighs and back
Secondary Dysmenorrhea:
-------------------------------
1. Starts about 1 week before menses and reach maximum on first day before reducing intensity for rest of menses peroid
2.dull aching pain in lower abdomen with radiation to the back
Symptoms may be associated with
1.vomiting,
2.urinary frequency,
3.headache,
4.painful breasts,
5.abdominal distension,
6.depression and
7.irritabilty.
What is the Treatment for Dysmenorrhea?
--------------------------------------------------
Primary Dysmenorrhea:
----------------------------
1.simple analgesics like paracetamol
2.Non-steroidal anti-infammatory drugs like Ponstan, Synflex
3.Antispasmodics
4.Tranquilliser or antidepressant
5.Muscle relaxant
6.female hormones
Secondary Dysmenorrhea:
-----------------------------------
1.Identify and treat the underlying cause(eg. antibiotics for PID)
2.Endometriosis may require a course of female hormones or surgery for control
3.Dilatation of the endocervical canal may help
What is the prognosis of Dysmenorrhea?
------------------------------------------------
Primary Dysmenorrhea may end with first pregnancy due to widening of uterine opening.
Secondary Dysmenorrhea prognosis depends on the treatment of causes.
Sunday, November 25, 2007
A Simple Guide to Laryngitis
A Simple Guide to Laryngitis
----------------------------------
What is Laryngitis?
------------------------
Laryngitis is the inflammation of the mucous membranes of the Laryngx which produces the sound of the voice.
What causes the Laryngitis?
---------------------------------
Laryngitis is caused by
1.bacterial or viral infections of the larynx.
2.excessive use of voice
3.inhalation of irritants such as cigarette smoke
Laryngitis is also associated with
1.bronchitis
2.pneumonia
3.whooping cough
4.diphtheria
What are the Symptoms of the Laryngitis?
--------------------------------------------------
Laryngitis produces mild but uncomfortable symptoms:
1.hoarseness of voice
2.loss of voice
3.pain on speaking
4.Fever low grade rare
How is the diagnosis of Laryngitis confirmed?
------------------------------------------------------
1.Symptoms of hoarseness or loss of voice
2.Physical examination of the throat may showed the presence of redness and swelling of the vocal cords with some pus discharge.
The movement of the vocal cords may be impeded.
Sometimes nodules may be found on the vocal cord due to excessive usage of voice.
What are the investigations done in Laryngitis?
-----------------------------------------------------------
1.nasal and throat swabs to determine the type of infection
2.Xray of the chest and neck to determine any pressure of other organs pressing on the larynx
3.A biopsy of the nodules on the vocal cords if present to exclude malignancy
What is the Treatment of Laryngitis?
---------------------------------------------
1.Rest the voice. A rested patient will recover faster.
2.Adequate warm fluids helps to keep the mucus membranes moist
3.Steam inhalations may help
4.Antibiotics if there is suspicion of bacterial infection.
5.Gargles and decongestants may help to soothe the throat and vocal cords
6.Avoid smoking.
What is the prognosis of Laryngitis?
------------------------------------------
Acute laryngitis usually clears up within 10 days.
Very rarely chronic laryngitis may cause hoarseness of voice for months or years.
----------------------------------
What is Laryngitis?
------------------------
Laryngitis is the inflammation of the mucous membranes of the Laryngx which produces the sound of the voice.
What causes the Laryngitis?
---------------------------------
Laryngitis is caused by
1.bacterial or viral infections of the larynx.
2.excessive use of voice
3.inhalation of irritants such as cigarette smoke
Laryngitis is also associated with
1.bronchitis
2.pneumonia
3.whooping cough
4.diphtheria
What are the Symptoms of the Laryngitis?
--------------------------------------------------
Laryngitis produces mild but uncomfortable symptoms:
1.hoarseness of voice
2.loss of voice
3.pain on speaking
4.Fever low grade rare
How is the diagnosis of Laryngitis confirmed?
------------------------------------------------------
1.Symptoms of hoarseness or loss of voice
2.Physical examination of the throat may showed the presence of redness and swelling of the vocal cords with some pus discharge.
The movement of the vocal cords may be impeded.
Sometimes nodules may be found on the vocal cord due to excessive usage of voice.
What are the investigations done in Laryngitis?
-----------------------------------------------------------
1.nasal and throat swabs to determine the type of infection
2.Xray of the chest and neck to determine any pressure of other organs pressing on the larynx
3.A biopsy of the nodules on the vocal cords if present to exclude malignancy
What is the Treatment of Laryngitis?
---------------------------------------------
1.Rest the voice. A rested patient will recover faster.
2.Adequate warm fluids helps to keep the mucus membranes moist
3.Steam inhalations may help
4.Antibiotics if there is suspicion of bacterial infection.
5.Gargles and decongestants may help to soothe the throat and vocal cords
6.Avoid smoking.
What is the prognosis of Laryngitis?
------------------------------------------
Acute laryngitis usually clears up within 10 days.
Very rarely chronic laryngitis may cause hoarseness of voice for months or years.
Saturday, November 24, 2007
A Simple Guide to Leprosy
A Simple Guide to Leprosy
----------------------------------
What is Leprosy?
---------------------
Leprosy or Hansen's disease is a chronic granulomatous disease caused by the bacteria mycobacterium leprae.
Who is at risk of contacting Leprosy?
--------------------------------------------
At present 10 countries: Brazil, Democratic Republic of the Congo, Guinea, India, Indonesia, Madagascar, Mozambique, Myanmar, Nepal and Tanzania account for 90 per cent of the disease in the world.
The disease affects mainly young people between 10-20 years of age, males more than females.
The exact mode of spread is unclear.
It is believed to be from person to person via nasal discharge, respiratory droplets and skin contact.
People prone to contacting the disease have:
1.weak immune system -these people develop multibacillary leprosy which is infectious,
Those with a stronger immune system develop paucibacillary leprosy which is non-infectious:
2.malnutrition and
3.unhygienic and crowded living conditions
What are the Signs & Symptoms of Leprosy?
----------------------------------------------------
The incubation period can vary from 1 year - 40 years.
Paucibacillary leprosy:
1.milder and non-infectious
2.one or more hypopigmented skin macules with loss of sensation.
3.Peripheral nerves may be damaged and enlarged.
Multibacillary leprosy :
1.numerous shiny, reddish nodules, thickened skin,
2.nasal discharge, nasal congestion and bleeding from the nose.
3.Distal peripheral nerves are thickened, enlarged and painful.
4.loss of eyelashes and eyebrows.
5.Skin smears are always positive for bacilli.
How is the diagnosis of Leprosy made:
---------------------------------------------
Diagnosis of leprosy is based on the following signs:
1.chronic skin lesions,
2.peripheral neuropathy,
3.thickened nerves,
4.muscle weakness
Confirmation of diagnosis is by
1.biopsy of skin lesions and thickened nerve.
2.Nasal and skin smears may show presence of leprosy bacteria.
What are the Complications of Leprosy?
------------------------------------------------
Complications include
1.damage to the peripheral nerves
2.numbness,
3.muscle weakness
4.paralysis with consequent claw hand or foot drop
5.skin 6. painful skin nodules.
6.loss of sensation, with resultant injuries
8.infections from injuries which can cause ulcers that damage the dermal tissues,
9.joints and bones infections resulting in the loss of extremities (toes and fingers)
10.secondary crippling deformities can occur in 25 per cent of cases not treated at an early stage.
What is the Treatment of Leprosy?
-----------------------------------------
Leprosy can be cured.
Early Treatment averts disability.
Multidrug therapy (MDT) consists of three drugs:
dapsone,
rifampicin and
clofazimine.
This drug combination effectively kills leprosy bacteria.
It prevents mutilations and deformities.
The 80 per cent with paucibacillary leprosy (PB) are non-infectious and cured within six months.
The remaining 20 to 30 per cent with the multibacillary form (MB) are cured within one year.
The drugs are safe with little side effects.
After the first dose of MDT, the patients are no longer infectious .
There is virtually no recurrence of the disease with treatment.
No resistance of the bacillus to MDT has been detected.
The chain of transmission of the leprosy is stopped.
What is the Preventive measures for Leprosy?
------------------------------------------------------
Prevention measures are:
1. early detection and treatment with MDT has prevented about 3 to 4 million people from being disabled.
2.Better hygience and nutrition
3.Better living conditions
Friday, November 23, 2007
A Simple Guide to Pelvic Inflammatory Disease
A Simple Guide to Pelvic Inflammatory Disease
--------------------------------------------------------
What is Pelvic Inflammatory Disease?
---------------------------------------------
Pelvic inflammatory disease (PID) is a general term used to describe inflammatory disorders of the upper female genital tract, such as infection of the uterus, fallopian tubes, ovaries and tissues around the reproductive organs.
These include endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis.
What is the cause of PID?
------------------------------
It is the result of infection from some sexually transmitted diseases especially chlamydia and gonorrhea.
The fallopian tubes and tissues in and near the uterus and ovaries are the most frequent organs damaged.
Sexually active women in their childbearing years are most likely to get PID.
Women under age 25 are more likely to develop PID than those older than 25.
The cervix of young women is not fully matured, and therefore more prone to be infected by STD.
Vaginal douching in women changes the vaginal bacteria flora in harmful ways, and can also force bacteria into the upper reproductive organs from the vagina.
Women with an intrauterine device (IUD) inserted has an increased risk of PID compared with women using other contraceptives or no contraceptive at all.
What are the signs and symptoms of PID?
--------------------------------------------------
Symptoms of PID can vary widely.
Women whose PID is caused by chlamydial infection may have mild symptoms or no symptoms at all even as serious damage is being done to her reproductive organs. Most cases of PID are not detected about two thirds of the time.
Common symptoms of PID are
1.lower abdominal pain
2.fever,
3.unusual vaginal discharge with a foul odor,
4.painful intercourse,
5.painful urination,
6.irregular menstrual bleeding, and
7.pain in the right upper abdomen (rare).
How is PID diagnosed?
---------------------------
Because the symptoms are often subtle and mild, most cases of PID go undetected.
Diagnosis is usually based on clinical findings:
1.lower abdominal pain
2.abnormal cervical or vaginal mucopurulent discharge
3.oral temperature >101°F (>38.3°C)
together with investigation findings
4.laboratory evidence of gonorrheal or chlamydial infection.
5.A wet specimen of vaginal fluid is able to detect the presence of concomitant infections ( bacterial vaginosis and trichomoniasis)
6. pelvic ultrasound is a helpful procedure for diagnosing PID.It can check the pelvic area to see whether there is an abscess or enlarged fallopian tubes.
7.laparoscopy is a minor surgical procedure in which a thin, flexible tube with a lighted end in inserted through a cut in the navel area to view the internal pelvic organs and to take specimens for testing.
Other criteria for diagnosing PID include the following:
8.endometrial biopsy with histopathologic evidence of endometritis;
9.transvaginal sonography or magnetic resonance imaging techniques showing thickened, fluid-filled tubes with or without free pelvic fluid or tubo-ovarian complex,
10.doppler studies suggesting pelvic infection
What are the complications of PID?
-----------------------------------------
Prompt and appropriate treatment can help prevent complications of PID.
Without treatment, PID can cause
1. permanent damage to the female reproductive organs.
Infection-causing bacteria can invade the fallopian tubes, damaging the lining of the tubes causing blockage of the fallopian tubes and preventing sperm from fertilising an egg.
2.Infertility also occur when the fallopian tubes are partially blocked or even slightly damaged as therm may find it difficult to reach the egg.
3.ectopic pregnancy may occur when the fertilized egg remains in the partially blocked fallopian tube and begins to grow.
As it grows, an ectopic pregnancy can cause rupture of the fallopian tube resulting in abdominal pain, internal bleeding, and death.
4.chronic pelvic pain that lasts for months or even years due to the inflammation, damage to the pelvic organs, and contraction of the scarred tissues.
5.endometrosis are blood clots in the pelvic region which occurs due to inflammation of the pelvis and can also cause pain during menses.
6. abscess formation in the reproductive organs or pelvis which can spread to the blood and cause septicemia.
What is the treatment for PID?
-------------------------------------
Treatment of PID should be initiated in
1.sexually active young women
2. pelvic or lower abdominal pain,
3. physical examination shows cervical motion tenderness, uterine tenderness or adnexal tenderness.
PID can be treated with several types of antibiotics(eg.clindamycin or metronidazole with doxycycline).
However, antibiotic treatment will not reverse any damage to the reproductive organs. If a woman has pelvic pain and other symptoms of PID, it is important that she seek care immediately.
Prompt antibiotic treatment can prevent severe damage to reproductive organs.
PID is usually treated with at least two antibiotics given by mouth or by injection.
Even if symptoms go away, the woman should finish taking all of the prescribed medicine.
This will help prevent the infection from returning.
Hospitalization to treat PID may be recommended if the woman
(1) is severely ill with nausea, vomiting, and high fever
(2) is pregnant;
(3) does not respond to or cannot take oral medication and needs intravenous antibiotics;
(4) has an abscess in the fallopian tube or ovary (tubo-ovarian abscess).
(5)surgical emergencies (e.g., appendicitis) cannot be excluded;
If symptoms continue or if an abscess does not go away, surgery may be needed.
Complications of PID such as chronic pelvic pain and scarring improve with surgery.
How can PID be prevented?
--------------------------------
1. transmission of STDs can be prevented by abstainance from sexual intercourse,
2. a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected can prevent STD.
3.Latex male condoms, when used consistently and correctly, can reduce the transmission of chlamydia and gonorrhea.
4.chlamydia testing of all sexually active women age 25 or younger and of older women with risk factors for chlamydial infections especially those with a new sex partner or multiple sex partners
5.Any genital symptoms such as an unusual sore, discharge with odor, burning during urination, or bleeding between menstrual cycles suggests a STD infection. Early treatment of STDs can prevent PID.
6. Intrauterine contraceptive devices containing levonorgestrel-and copper-containing devices may cause PID and should be removed if antibiotics does not cure the PID.
--------------------------------------------------------
What is Pelvic Inflammatory Disease?
---------------------------------------------
Pelvic inflammatory disease (PID) is a general term used to describe inflammatory disorders of the upper female genital tract, such as infection of the uterus, fallopian tubes, ovaries and tissues around the reproductive organs.
These include endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis.
What is the cause of PID?
------------------------------
It is the result of infection from some sexually transmitted diseases especially chlamydia and gonorrhea.
The fallopian tubes and tissues in and near the uterus and ovaries are the most frequent organs damaged.
Sexually active women in their childbearing years are most likely to get PID.
Women under age 25 are more likely to develop PID than those older than 25.
The cervix of young women is not fully matured, and therefore more prone to be infected by STD.
Vaginal douching in women changes the vaginal bacteria flora in harmful ways, and can also force bacteria into the upper reproductive organs from the vagina.
Women with an intrauterine device (IUD) inserted has an increased risk of PID compared with women using other contraceptives or no contraceptive at all.
What are the signs and symptoms of PID?
--------------------------------------------------
Symptoms of PID can vary widely.
Women whose PID is caused by chlamydial infection may have mild symptoms or no symptoms at all even as serious damage is being done to her reproductive organs. Most cases of PID are not detected about two thirds of the time.
Common symptoms of PID are
1.lower abdominal pain
2.fever,
3.unusual vaginal discharge with a foul odor,
4.painful intercourse,
5.painful urination,
6.irregular menstrual bleeding, and
7.pain in the right upper abdomen (rare).
How is PID diagnosed?
---------------------------
Because the symptoms are often subtle and mild, most cases of PID go undetected.
Diagnosis is usually based on clinical findings:
1.lower abdominal pain
2.abnormal cervical or vaginal mucopurulent discharge
3.oral temperature >101°F (>38.3°C)
together with investigation findings
4.laboratory evidence of gonorrheal or chlamydial infection.
5.A wet specimen of vaginal fluid is able to detect the presence of concomitant infections ( bacterial vaginosis and trichomoniasis)
6. pelvic ultrasound is a helpful procedure for diagnosing PID.It can check the pelvic area to see whether there is an abscess or enlarged fallopian tubes.
7.laparoscopy is a minor surgical procedure in which a thin, flexible tube with a lighted end in inserted through a cut in the navel area to view the internal pelvic organs and to take specimens for testing.
Other criteria for diagnosing PID include the following:
8.endometrial biopsy with histopathologic evidence of endometritis;
9.transvaginal sonography or magnetic resonance imaging techniques showing thickened, fluid-filled tubes with or without free pelvic fluid or tubo-ovarian complex,
10.doppler studies suggesting pelvic infection
What are the complications of PID?
-----------------------------------------
Prompt and appropriate treatment can help prevent complications of PID.
Without treatment, PID can cause
1. permanent damage to the female reproductive organs.
Infection-causing bacteria can invade the fallopian tubes, damaging the lining of the tubes causing blockage of the fallopian tubes and preventing sperm from fertilising an egg.
2.Infertility also occur when the fallopian tubes are partially blocked or even slightly damaged as therm may find it difficult to reach the egg.
3.ectopic pregnancy may occur when the fertilized egg remains in the partially blocked fallopian tube and begins to grow.
As it grows, an ectopic pregnancy can cause rupture of the fallopian tube resulting in abdominal pain, internal bleeding, and death.
4.chronic pelvic pain that lasts for months or even years due to the inflammation, damage to the pelvic organs, and contraction of the scarred tissues.
5.endometrosis are blood clots in the pelvic region which occurs due to inflammation of the pelvis and can also cause pain during menses.
6. abscess formation in the reproductive organs or pelvis which can spread to the blood and cause septicemia.
What is the treatment for PID?
-------------------------------------
Treatment of PID should be initiated in
1.sexually active young women
2. pelvic or lower abdominal pain,
3. physical examination shows cervical motion tenderness, uterine tenderness or adnexal tenderness.
PID can be treated with several types of antibiotics(eg.clindamycin or metronidazole with doxycycline).
However, antibiotic treatment will not reverse any damage to the reproductive organs. If a woman has pelvic pain and other symptoms of PID, it is important that she seek care immediately.
Prompt antibiotic treatment can prevent severe damage to reproductive organs.
PID is usually treated with at least two antibiotics given by mouth or by injection.
Even if symptoms go away, the woman should finish taking all of the prescribed medicine.
This will help prevent the infection from returning.
Hospitalization to treat PID may be recommended if the woman
(1) is severely ill with nausea, vomiting, and high fever
(2) is pregnant;
(3) does not respond to or cannot take oral medication and needs intravenous antibiotics;
(4) has an abscess in the fallopian tube or ovary (tubo-ovarian abscess).
(5)surgical emergencies (e.g., appendicitis) cannot be excluded;
If symptoms continue or if an abscess does not go away, surgery may be needed.
Complications of PID such as chronic pelvic pain and scarring improve with surgery.
How can PID be prevented?
--------------------------------
1. transmission of STDs can be prevented by abstainance from sexual intercourse,
2. a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected can prevent STD.
3.Latex male condoms, when used consistently and correctly, can reduce the transmission of chlamydia and gonorrhea.
4.chlamydia testing of all sexually active women age 25 or younger and of older women with risk factors for chlamydial infections especially those with a new sex partner or multiple sex partners
5.Any genital symptoms such as an unusual sore, discharge with odor, burning during urination, or bleeding between menstrual cycles suggests a STD infection. Early treatment of STDs can prevent PID.
6. Intrauterine contraceptive devices containing levonorgestrel-and copper-containing devices may cause PID and should be removed if antibiotics does not cure the PID.
Thursday, November 22, 2007
A Simple Guide to Bacterial Vaginosis
A Simple Guide to Bacterial Vaginosis
---------------------------------------------
What is bacterial vaginosis?
----------------------------------
Bacterial Vaginosis (BV) is a condition in women where the normal balance of lactobacillus bacteria in the vagina is disrupted and replaced by an overgrowth of high concentrations of anaerobic bacteria (e.g., Prevotella sp. , Mobiluncus sp.), G. vaginalis, and Mycoplasma hominis.
The condition is characterised by vaginal discharge, odor, pain and itching.
Bacterial Vaginosis is the most common vaginal infection in women after puberty.
How is bacterial vaginosis spread?
-------------------------------------------
BV is associated with an imbalance in the lactobacillus bacteria in a woman's vagina. The cause of this imbalance is not known.
Some possible causes of this imbalance are:
1.Having multiple sex partners or a new sex partner
2.Vaginal Douching which alter the pH and bacterial flora of vagina
3.Using an intrauterine device for preventing pregnancy.
Women that have never had sexual intercourse are rarely affected.
What are the symptoms of bacterial vaginosis?
-------------------------------------------------------
Women with typical Bacterial Vaginosis symptoms have:
1.an abnormal vaginal discharge with an unpleasant fish-like odor especially after intercourse.
The discharge is usually greyish, semiadherent, homogeneous.
Sometimes it can be thin,cream to green in colour and frothy.
2.burning sensation during urination
3.itching around the outside of the vagina,
More than 50% women with BV report no symptoms at all.
What are the complications of bacterial vaginosis?
-------------------------------------------------------------
In most cases, there are no complications.
Some serious complications from BV include:
1.pelvic inflammatory disease (PID) especially after surgery like hysterectomy
2.endometritis,
3.increased susceptibility to other STDs, such as chlamydia, gonorrhea and HIV.
4.increased risk for some complications of pregnancy such as ectopic pregnancy and premature births.
How is bacterial vaginosis diagnosed?
---------------------------------------------
1.vagina examination for homogeneous, thin, white discharge that smoothly coats the vaginal walls;
2.laboratory tests on a sample of vaginal fluid:
a.presence of clue cells on microscopic examination;
b.pH of vaginal fluid >4.5;
c.fishy odor of vaginal discharge before or after addition of 1% KOH (the whiff test).
d.Gram stain is used to detect the relative concentration of lactobacilli (long Gram-positive rods), Gram-negative and Gram-variable rods and cocci ( G. vaginalis, Prevotella, Porphyromonas, and peptostreptococci), and curved Gram-negative rods (Mobiluncus) characteristic of BV.
What is the treatment for bacterial vaginosis?
------------------------------------------------------
All women suspected of BV should be treated to avoid such complications as Pelvic Inflammatory Disease.
Treatment is especially important for pregnant women.
All pregnant women who have symptoms of BV should be checked and treated.
BV is treatable with antibiotics :
metronidazole 500 mg orally twice a day for 7 days
OR
Metronidazole gel, 0.75%,5 g intravaginally, once a day for 5 days
OR
Clindamycin 300 mg orally twice a day for 7 days
OR
Clindamycin cream, 2%,5 g intravaginally at bedtime for 7 days
Either can be used with non-pregnant or pregnant women, but the recommended dosages differ.
Patients treated with metronidazole should be advised to avoid consuming alcohol for 24 hours.
BV can recur after treatment.
How can bacterial vaginosis be prevented?
--------------------------------------------------
Since BV is seldom found in women who have never had intercourse.and is associated with having a new sex partner or having multiple sex partners, prevention measures are aimed at sexual transmission:
1. Abstain from sex
2.Do not have multiple sex partners.
3.Do not use vaginal douche.
4.Take all of the medicine prescribed for treatment of BV even if there are no more symptoms.
---------------------------------------------
What is bacterial vaginosis?
----------------------------------
Bacterial Vaginosis (BV) is a condition in women where the normal balance of lactobacillus bacteria in the vagina is disrupted and replaced by an overgrowth of high concentrations of anaerobic bacteria (e.g., Prevotella sp. , Mobiluncus sp.), G. vaginalis, and Mycoplasma hominis.
The condition is characterised by vaginal discharge, odor, pain and itching.
Bacterial Vaginosis is the most common vaginal infection in women after puberty.
How is bacterial vaginosis spread?
-------------------------------------------
BV is associated with an imbalance in the lactobacillus bacteria in a woman's vagina. The cause of this imbalance is not known.
Some possible causes of this imbalance are:
1.Having multiple sex partners or a new sex partner
2.Vaginal Douching which alter the pH and bacterial flora of vagina
3.Using an intrauterine device for preventing pregnancy.
Women that have never had sexual intercourse are rarely affected.
What are the symptoms of bacterial vaginosis?
-------------------------------------------------------
Women with typical Bacterial Vaginosis symptoms have:
1.an abnormal vaginal discharge with an unpleasant fish-like odor especially after intercourse.
The discharge is usually greyish, semiadherent, homogeneous.
Sometimes it can be thin,cream to green in colour and frothy.
2.burning sensation during urination
3.itching around the outside of the vagina,
More than 50% women with BV report no symptoms at all.
What are the complications of bacterial vaginosis?
-------------------------------------------------------------
In most cases, there are no complications.
Some serious complications from BV include:
1.pelvic inflammatory disease (PID) especially after surgery like hysterectomy
2.endometritis,
3.increased susceptibility to other STDs, such as chlamydia, gonorrhea and HIV.
4.increased risk for some complications of pregnancy such as ectopic pregnancy and premature births.
How is bacterial vaginosis diagnosed?
---------------------------------------------
1.vagina examination for homogeneous, thin, white discharge that smoothly coats the vaginal walls;
2.laboratory tests on a sample of vaginal fluid:
a.presence of clue cells on microscopic examination;
b.pH of vaginal fluid >4.5;
c.fishy odor of vaginal discharge before or after addition of 1% KOH (the whiff test).
d.Gram stain is used to detect the relative concentration of lactobacilli (long Gram-positive rods), Gram-negative and Gram-variable rods and cocci ( G. vaginalis, Prevotella, Porphyromonas, and peptostreptococci), and curved Gram-negative rods (Mobiluncus) characteristic of BV.
What is the treatment for bacterial vaginosis?
------------------------------------------------------
All women suspected of BV should be treated to avoid such complications as Pelvic Inflammatory Disease.
Treatment is especially important for pregnant women.
All pregnant women who have symptoms of BV should be checked and treated.
BV is treatable with antibiotics :
metronidazole 500 mg orally twice a day for 7 days
OR
Metronidazole gel, 0.75%,5 g intravaginally, once a day for 5 days
OR
Clindamycin 300 mg orally twice a day for 7 days
OR
Clindamycin cream, 2%,5 g intravaginally at bedtime for 7 days
Either can be used with non-pregnant or pregnant women, but the recommended dosages differ.
Patients treated with metronidazole should be advised to avoid consuming alcohol for 24 hours.
BV can recur after treatment.
How can bacterial vaginosis be prevented?
--------------------------------------------------
Since BV is seldom found in women who have never had intercourse.and is associated with having a new sex partner or having multiple sex partners, prevention measures are aimed at sexual transmission:
1. Abstain from sex
2.Do not have multiple sex partners.
3.Do not use vaginal douche.
4.Take all of the medicine prescribed for treatment of BV even if there are no more symptoms.
Wednesday, November 21, 2007
A Simple Guide to Measles
A Simple Guide to Measles
--------------------------------
What is Measles?
---------------------
Measles is usually a contagious childhood infection caused by the measles virus, one of the paromyxovirus.
It is characterised by typical prodromal symptoms, generalised rash and Koplik's spots in the mouth.
Who is at risk for Measles?
--------------------------------
Any one at any age can contract measles but it usually occurs in childhood.
Spread is usually by infected persons either from mucous discharges from their coughing and sneezing, or from contact with their skin rash,contaminated items and surfaces.
Usually a person is contagious for about two days before symptoms appear, and up to five days after appearance of the rash.
What are the Symptoms of Measles?
-------------------------------------------
There is a prodromal peroid of 5 to 7 days after contact with a infected person.
Early symptoms include:
1.high fever
2.coughing,
3.runny nose, stuffy nose,
4.tiredness,
5.red eyes, tearing. ,
6.Koplik's spots (white spots with a red background , located on the inside of the cheeks near the back molars start to appear 2-4 days after the fever.
7.measles rash usually occurs after the appearance of the Koplik's spots.
The rash is typically red,maculopapular, and starts from behind the ears and face, then spreads downward to the neck, trunk, limbs, and soles. Once it reaches the soles, the rash begins to fade in about four days , first the head and neck, then trunk and limbs. There may be a brownish discoloration in areas of affected skin rashes but this is only temporary.
8. enlarged lymph glands may be felt in the neck and groins
9.inflammation of the eyes (conjunctivitis) with tearing may also occurs.
10. diarrhoea and vomiting may occurs in some patients.
Adults tend to suffer more severe symptoms than children do.
People who have had measles develop a natural immunity and cannot contract it again.
What are the Complications of Measles?
------------------------------------------------
1.Ear infection (Otitis Media) is a common complication of measles.
2.pneumonia in very young children and older patients may be dangerous.
3.encephalitis (brain infection)may ocur in 1 out of 600 patients putting them at risk of suffering seizures, coma or dying.
4.the digestive organs (including the liver),the heart muscle or the kidneys may be damaged in rare cases
A pregnant woman who develops a measles infection has
1.an increased risk of premature labour,
2.miscarriage
3.delivery of a low birth weight baby.
What is the Treatment for Measles?
------------------------------------------
There is no cure for measles.
Treatment is therefore symptomatic.
Fever symptoms are treated with Paracetamol.
Children should not be given aspirin due to the risk of Reye's Syndrome which affects the brain
Itch may be controlled by antihistamines which can also help to relieve the runny nose.
Antibiotics may be given if there is superimposed secondary bacterial infection such as otitis emdia and pneumonia.
Cough mixtures may be given to relieve the cough.
Plenty of bed rest is necessary.
Lots of fluids helps to prevent dehydration.
A cool-mist humidifier to soothe respiratory passages may help.
Most patients recover completely from measles.
Death is extremely rare (one out of every 1000 cases), usually from pneumonia or encephalitis.
How do You prevent Measles?
-------------------------------------
Measles can be prevented with the measles vaccine, which is usually given to children at the age of 15 months as part of the MMR (measles, mumps and rubella) combination.
A second MMR vaccine is now given at the age of 12 years.
--------------------------------
What is Measles?
---------------------
Measles is usually a contagious childhood infection caused by the measles virus, one of the paromyxovirus.
It is characterised by typical prodromal symptoms, generalised rash and Koplik's spots in the mouth.
Who is at risk for Measles?
--------------------------------
Any one at any age can contract measles but it usually occurs in childhood.
Spread is usually by infected persons either from mucous discharges from their coughing and sneezing, or from contact with their skin rash,contaminated items and surfaces.
Usually a person is contagious for about two days before symptoms appear, and up to five days after appearance of the rash.
What are the Symptoms of Measles?
-------------------------------------------
There is a prodromal peroid of 5 to 7 days after contact with a infected person.
Early symptoms include:
1.high fever
2.coughing,
3.runny nose, stuffy nose,
4.tiredness,
5.red eyes, tearing. ,
6.Koplik's spots (white spots with a red background , located on the inside of the cheeks near the back molars start to appear 2-4 days after the fever.
7.measles rash usually occurs after the appearance of the Koplik's spots.
The rash is typically red,maculopapular, and starts from behind the ears and face, then spreads downward to the neck, trunk, limbs, and soles. Once it reaches the soles, the rash begins to fade in about four days , first the head and neck, then trunk and limbs. There may be a brownish discoloration in areas of affected skin rashes but this is only temporary.
8. enlarged lymph glands may be felt in the neck and groins
9.inflammation of the eyes (conjunctivitis) with tearing may also occurs.
10. diarrhoea and vomiting may occurs in some patients.
Adults tend to suffer more severe symptoms than children do.
People who have had measles develop a natural immunity and cannot contract it again.
What are the Complications of Measles?
------------------------------------------------
1.Ear infection (Otitis Media) is a common complication of measles.
2.pneumonia in very young children and older patients may be dangerous.
3.encephalitis (brain infection)may ocur in 1 out of 600 patients putting them at risk of suffering seizures, coma or dying.
4.the digestive organs (including the liver),the heart muscle or the kidneys may be damaged in rare cases
A pregnant woman who develops a measles infection has
1.an increased risk of premature labour,
2.miscarriage
3.delivery of a low birth weight baby.
What is the Treatment for Measles?
------------------------------------------
There is no cure for measles.
Treatment is therefore symptomatic.
Fever symptoms are treated with Paracetamol.
Children should not be given aspirin due to the risk of Reye's Syndrome which affects the brain
Itch may be controlled by antihistamines which can also help to relieve the runny nose.
Antibiotics may be given if there is superimposed secondary bacterial infection such as otitis emdia and pneumonia.
Cough mixtures may be given to relieve the cough.
Plenty of bed rest is necessary.
Lots of fluids helps to prevent dehydration.
A cool-mist humidifier to soothe respiratory passages may help.
Most patients recover completely from measles.
Death is extremely rare (one out of every 1000 cases), usually from pneumonia or encephalitis.
How do You prevent Measles?
-------------------------------------
Measles can be prevented with the measles vaccine, which is usually given to children at the age of 15 months as part of the MMR (measles, mumps and rubella) combination.
A second MMR vaccine is now given at the age of 12 years.
Tuesday, November 20, 2007
A Simple Guide to Hepatitis C
A Simple Guide to Hepatitis C
-----------------------------------
What is Hepatitis C?
------------------------
Hepatitis C is a serious inflammatory liver disease caused by a virus which is called hepatitis C virus (HCV).
Who is at risk of Hepatitis C?
-----------------------------------
Hepatitis C virus infection is one of the most common chronic bloodborne infection.
Persons at risk for infection are:
1. injection-drug users
2. blood transfusions or solid organ transplant recipients before July 1992
3. on long-term dialysis
4. sexual exposure to infected HCV carriers(rare)
What are the symptoms of Hepatitis C?
-----------------------------------------------
Persons who has been newly infected with HCV usually are asymptomatic or have a mild clinical illness:
1.mild fever and bodyaches
2.slight jaundice
3.nausea
4.enlarged liver
How do you diagnose Hepatitis C?
----------------------------------------
A person exposed to Hepatitis C infection can detect HCV RNA in blood within 1-3 weeks.
The time from exposure to antibody to HCV seroconversion(or Anti-HCV) is 8-9 weeks.
Therefore diagnosis can usually be confirmed by :
1.the presence of Anti-HCV in 98% of infected persons within 6 months of exposure.
2.Reverse transcriptase polymerase chain reaction to detect HCV RNA
Chronic HCV infection occurs in 70% of HCV-infected persons.
Two thirds of these have evidence of active liver disease but may not be aware of their infection because they are not clinically ill.
Infected HCV carriers can transmit the illness to others and develop chronic liver diseases for years after infection.
What is the treatment of Hepatitis C?
--------------------------------------------
There is no cure for HCV infections.
Persons found to be anti-HCV positive should be evaluated for presence of
1.active infection,
2.presence or development of Chronic Liver Disease,
3.for possible treatment of HCV.
Combination therapy with interferon and ribavirin may help in treatment of patients with chronic hepatitis C.
What is the Prevention for Hepatitis C?
----------------------------------------------
No vaccine for hepatitis C is available.
Immune globulin is not effective in preventing HCV infection after exposure.
Primary prevention is to reduce or eliminate HCV transmission.
Secondary prevention activities is to reduce liver and other chronic diseases in HCV-infected persons by identifying them and providing appropriate medical management and antiviral therapy.
Persons who test positive for anti-HCV should be provided information regarding
1) how to protect their liver from further harm by avoiding alcohol and taking any new medicines (including OTC and herbals)
2) how to prevent transmission to others
a) not donate blood, body organs, other tissue, or semen;
b) not share any personal items that might have blood on them (e.g., toothbrushes and razors);
c) cover cuts and sores on the skin to keep from spreading infectious blood or secretions
3) the need for medical evaluation including assessment of liver function tests, assessment for severity of liver disease and possible treatment, and determination of the need for hepatitis A and B.
HCV-positive women do not need to avoid pregnancy or breastfeeding.
Regardless of test results, persons who use or inject illegal drugs should be counseled to
1.stop using and injecting drugs;
2.enter a program to eradicate complete substance abuse treatment, including relapse prevention;
3.take the following steps to reduce personal and public health risks, if they continue to inject drugs:
4.never reuse or share syringes, water, or drug preparation equipment;
5. use only syringes obtained from a reliable source (e.g., pharmacies);
6.use a new, sterile syringe to prepare and inject drugs;
7.get vaccinated for hepatitis A and B.
-----------------------------------
What is Hepatitis C?
------------------------
Hepatitis C is a serious inflammatory liver disease caused by a virus which is called hepatitis C virus (HCV).
Who is at risk of Hepatitis C?
-----------------------------------
Hepatitis C virus infection is one of the most common chronic bloodborne infection.
Persons at risk for infection are:
1. injection-drug users
2. blood transfusions or solid organ transplant recipients before July 1992
3. on long-term dialysis
4. sexual exposure to infected HCV carriers(rare)
What are the symptoms of Hepatitis C?
-----------------------------------------------
Persons who has been newly infected with HCV usually are asymptomatic or have a mild clinical illness:
1.mild fever and bodyaches
2.slight jaundice
3.nausea
4.enlarged liver
How do you diagnose Hepatitis C?
----------------------------------------
A person exposed to Hepatitis C infection can detect HCV RNA in blood within 1-3 weeks.
The time from exposure to antibody to HCV seroconversion(or Anti-HCV) is 8-9 weeks.
Therefore diagnosis can usually be confirmed by :
1.the presence of Anti-HCV in 98% of infected persons within 6 months of exposure.
2.Reverse transcriptase polymerase chain reaction to detect HCV RNA
Chronic HCV infection occurs in 70% of HCV-infected persons.
Two thirds of these have evidence of active liver disease but may not be aware of their infection because they are not clinically ill.
Infected HCV carriers can transmit the illness to others and develop chronic liver diseases for years after infection.
What is the treatment of Hepatitis C?
--------------------------------------------
There is no cure for HCV infections.
Persons found to be anti-HCV positive should be evaluated for presence of
1.active infection,
2.presence or development of Chronic Liver Disease,
3.for possible treatment of HCV.
Combination therapy with interferon and ribavirin may help in treatment of patients with chronic hepatitis C.
What is the Prevention for Hepatitis C?
----------------------------------------------
No vaccine for hepatitis C is available.
Immune globulin is not effective in preventing HCV infection after exposure.
Primary prevention is to reduce or eliminate HCV transmission.
Secondary prevention activities is to reduce liver and other chronic diseases in HCV-infected persons by identifying them and providing appropriate medical management and antiviral therapy.
Persons who test positive for anti-HCV should be provided information regarding
1) how to protect their liver from further harm by avoiding alcohol and taking any new medicines (including OTC and herbals)
2) how to prevent transmission to others
a) not donate blood, body organs, other tissue, or semen;
b) not share any personal items that might have blood on them (e.g., toothbrushes and razors);
c) cover cuts and sores on the skin to keep from spreading infectious blood or secretions
3) the need for medical evaluation including assessment of liver function tests, assessment for severity of liver disease and possible treatment, and determination of the need for hepatitis A and B.
HCV-positive women do not need to avoid pregnancy or breastfeeding.
Regardless of test results, persons who use or inject illegal drugs should be counseled to
1.stop using and injecting drugs;
2.enter a program to eradicate complete substance abuse treatment, including relapse prevention;
3.take the following steps to reduce personal and public health risks, if they continue to inject drugs:
4.never reuse or share syringes, water, or drug preparation equipment;
5. use only syringes obtained from a reliable source (e.g., pharmacies);
6.use a new, sterile syringe to prepare and inject drugs;
7.get vaccinated for hepatitis A and B.
Monday, November 19, 2007
A Simple Guide to Lice
A Simple Guide to Lice
---------------------------
What is Lice?
------------------
Lice is a parasite called Pediculosis which can live on your skin.
Whare are the locations of Lice?
-------------------------------------
It can occur at the
1. head or Pediculosis Capitis and
2..body or Pediculosis corporis.
3. pubis or Pediculosis Pubis
Pediculosis Capitis
-----------------------
Pediculosis Capitis (hair lice) causes itchiness of the scalp and produce nits(small ovoid eggs) on the hair shafts.
It is spread by personal contact, combs, hats, caps.
The incidence is high in school children and people with long hair.
Pediculosis corporis
------------------------
Pediculosis corporis (body lice) also causes itchiness of the skin of the body.
It is also spread by personal contact, clothing and is associated with poor personal hygience.
Pediculosis Pubis
---------------------
Pediculosis pubis (pubic lice) usually cause itchiness of the pubic area.
There may be lice or nits on their anogenital hair.
Pediculosis pubis is usually spread by sexual contact.
What are the symptoms of Lice?
--------------------------------------
1. Itchiness of the skin with scratch marks
2. Small red bites.
3. Excoriation of the skin
4. Nits on scalp and pubic hairs
5. Urticaria
6. bacterial infections at sites of bites.
7. lice and eggs sometimes seen on underwear or clothing.
How do you diagnose Lice?
-------------------------------
The lice and nits can be seen with a magnifying glass.
What is the treatment of Lice?
------------------------------------------
There are various topical medications used to treat lice:
Benzyl Benzoate lotion applied to affected areas and washed off after 30 minutes
Permethrin 1% cream rinse applied to affected areas and washed off after 10 minutes
Malathion 0.5% lotion applied for 12 hours and washed off
Resistance to pediculcides is widespread and increasing.
Nits should be removed with a fine comb.
Bedding and clothing should be machine-washed, machine-dried using the heat cycle, and allowed to dry in the sun.
Patients should avoid sexual contact with their sex partner until all have been treated.
All family members should be treated in order to eradicate the lice.
---------------------------
What is Lice?
------------------
Lice is a parasite called Pediculosis which can live on your skin.
Whare are the locations of Lice?
-------------------------------------
It can occur at the
1. head or Pediculosis Capitis and
2..body or Pediculosis corporis.
3. pubis or Pediculosis Pubis
Pediculosis Capitis
-----------------------
Pediculosis Capitis (hair lice) causes itchiness of the scalp and produce nits(small ovoid eggs) on the hair shafts.
It is spread by personal contact, combs, hats, caps.
The incidence is high in school children and people with long hair.
Pediculosis corporis
------------------------
Pediculosis corporis (body lice) also causes itchiness of the skin of the body.
It is also spread by personal contact, clothing and is associated with poor personal hygience.
Pediculosis Pubis
---------------------
Pediculosis pubis (pubic lice) usually cause itchiness of the pubic area.
There may be lice or nits on their anogenital hair.
Pediculosis pubis is usually spread by sexual contact.
What are the symptoms of Lice?
--------------------------------------
1. Itchiness of the skin with scratch marks
2. Small red bites.
3. Excoriation of the skin
4. Nits on scalp and pubic hairs
5. Urticaria
6. bacterial infections at sites of bites.
7. lice and eggs sometimes seen on underwear or clothing.
How do you diagnose Lice?
-------------------------------
The lice and nits can be seen with a magnifying glass.
What is the treatment of Lice?
------------------------------------------
There are various topical medications used to treat lice:
Benzyl Benzoate lotion applied to affected areas and washed off after 30 minutes
Permethrin 1% cream rinse applied to affected areas and washed off after 10 minutes
Malathion 0.5% lotion applied for 12 hours and washed off
Resistance to pediculcides is widespread and increasing.
Nits should be removed with a fine comb.
Bedding and clothing should be machine-washed, machine-dried using the heat cycle, and allowed to dry in the sun.
Patients should avoid sexual contact with their sex partner until all have been treated.
All family members should be treated in order to eradicate the lice.
Sunday, November 18, 2007
A Simple Guide to Syphilis
A Simple Guide to Syphilis
--------------------------------
What is Syphilis?
----------------------
Syphilis is a infectious sexually transmitted disease caused by the bacterium Treponema pallidum.
It can be acute, subacute or chronic depending on the stage.
How is Syphilis spread?
----------------------------
Syphilis is passed from a infected person through sexual contact with a infected sore which occur mainly on the external genitals, anus, or rectum.
The lips and the mouth may also have sores.
The bacteria can penetrate through normal mucous membrane and minor abrasions of the epithelium.
Transmission of the organism usually occurs during sexual contact.
Pregnant women with the disease can pass it to the babies they are carrying.
What are the symptoms of Syphilis?
--------------------------------------------
The signs and symptoms of syphilis may occur in four stages:
Primary
----------
These signs may occur from 10 to 90 days after exposure:
1.A small, firm, painless sore (chancre) appears on the body where the syphilis enter the body, usually the genitals, rectum, or lips.
A single chancre is typical, but there may be multiple sores.
2.Enlarged lymph nodes in your groin.
The chancre lasts 3 to 6 weeks, and it heals without treatment.
However, if untreated, the infection progresses to the secondary stage.
Secondary
----------
The signs and symptoms of secondary syphilis may begin two to 10 weeks after the chancre appears, and may include:
1.Rash marked by red or reddish-brown sores over any area of the body especially the palms and soles. The rash usually does not cause itching.
2.Fever
3.Fatigue and a vague feeling of discomfort
4.swollen lymph glands,
5.sore throat,
6.weight loss,
7.Soreness and aching
The signs and symptoms of secondary syphilis will resolve with or without treatment.
Without treatment, the infection will progress to the latent and late stages of disease.
Latent
--------
A period called latent syphilis in which no symptoms are present may follow the secondary stage.
Signs and symptoms may not appear until the disease may progress to the tertiary stage.
Tertiary
----------
Without treatment, syphilis bacteria may spread, leading to serious internal organ damage including the brain, nerves, eyes, heart, blood vessels, liver, bones,joints and finally death years after the original infection.
1.Neurological problems. These may include stroke; infection and inflammation of the membranes and fluid surrounding the brain and spinal cord (meningitis); poor muscle coordination; numbness; paralysis; deafness or visual problems; personality changes; and dementia.
2.Cardiovascular problems. These may include bulging (aneurysm) and inflammation of the aorta and of other blood vessels.
Syphilis may also cause valvular heart disease, such as aortic valve insufficiency.
Many people infected with syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated.
What is the danger of Syphilis during pregnancy?
----------------------------------------------------------
The syphilis bacterium can infect the baby of a woman during her pregnancy. Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth or of giving birth to a baby who dies shortly after birth.
An infected baby may be born without signs or symptoms of disease.
Untreated babies may become developmentally delayed, have seizures, or die.
How do you diagnose Syphilis?
---------------------------------------
1. dark-field microscope: examining material from a chancre using this microscope.
If syphilis bacteria are present in the sore, they will show up when observed through the microscope.
2.A blood test for syphilis antibodies is accurate, safe, and inexpensive. There will be some antibodies in the blood for months even when the disease has been successfully treated.
Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, every pregnant woman should have a blood test for syphilis.
What is the treatment of Syphilis?
-----------------------------------------
Syphilis is easy to cure in its early stages.
Treatment with intramuscular injection of penicillin can kill the organism that causes syphilis.
If you're allergic to penicillin, other antibiotics such as erythromycin will kill the syphilis bacterium.
Treatment however will not repair damage already done.
Left untreated, the disease can lead to serious complications or death.
Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed.
Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.
Even if you were treated for syphilis during your pregnancy, your newborn child should receive antibiotic treatment.
To make sure you're responding to the usual dosage of penicillin, the doctor likely will want you to have periodic blood tests.
Blood test may remain positive up to 18 months even after successful treatment of syphilis.
Having syphilis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.
How do you prevent Syphilis?
---------------------------
The surest way to avoid transmission of sexually transmitted diseases, including syphilis, is to 1.abstain from sexual contact
2.in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
3.Avoiding alcohol and drug use may also help prevent transmission of syphilis because these activities may lead to risky sexual behavior.
4.Correct and consistent use of latex condoms can reduce the risk of syphilis only when the infected area or site of potential exposure is protected.
5.Complications from syphilis such as neurosyphilis are rare because of better diagnosis and treatment
--------------------------------
What is Syphilis?
----------------------
Syphilis is a infectious sexually transmitted disease caused by the bacterium Treponema pallidum.
It can be acute, subacute or chronic depending on the stage.
How is Syphilis spread?
----------------------------
Syphilis is passed from a infected person through sexual contact with a infected sore which occur mainly on the external genitals, anus, or rectum.
The lips and the mouth may also have sores.
The bacteria can penetrate through normal mucous membrane and minor abrasions of the epithelium.
Transmission of the organism usually occurs during sexual contact.
Pregnant women with the disease can pass it to the babies they are carrying.
What are the symptoms of Syphilis?
--------------------------------------------
The signs and symptoms of syphilis may occur in four stages:
Primary
----------
These signs may occur from 10 to 90 days after exposure:
1.A small, firm, painless sore (chancre) appears on the body where the syphilis enter the body, usually the genitals, rectum, or lips.
A single chancre is typical, but there may be multiple sores.
2.Enlarged lymph nodes in your groin.
The chancre lasts 3 to 6 weeks, and it heals without treatment.
However, if untreated, the infection progresses to the secondary stage.
Secondary
----------
The signs and symptoms of secondary syphilis may begin two to 10 weeks after the chancre appears, and may include:
1.Rash marked by red or reddish-brown sores over any area of the body especially the palms and soles. The rash usually does not cause itching.
2.Fever
3.Fatigue and a vague feeling of discomfort
4.swollen lymph glands,
5.sore throat,
6.weight loss,
7.Soreness and aching
The signs and symptoms of secondary syphilis will resolve with or without treatment.
Without treatment, the infection will progress to the latent and late stages of disease.
Latent
--------
A period called latent syphilis in which no symptoms are present may follow the secondary stage.
Signs and symptoms may not appear until the disease may progress to the tertiary stage.
Tertiary
----------
Without treatment, syphilis bacteria may spread, leading to serious internal organ damage including the brain, nerves, eyes, heart, blood vessels, liver, bones,joints and finally death years after the original infection.
1.Neurological problems. These may include stroke; infection and inflammation of the membranes and fluid surrounding the brain and spinal cord (meningitis); poor muscle coordination; numbness; paralysis; deafness or visual problems; personality changes; and dementia.
2.Cardiovascular problems. These may include bulging (aneurysm) and inflammation of the aorta and of other blood vessels.
Syphilis may also cause valvular heart disease, such as aortic valve insufficiency.
Many people infected with syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated.
What is the danger of Syphilis during pregnancy?
----------------------------------------------------------
The syphilis bacterium can infect the baby of a woman during her pregnancy. Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth or of giving birth to a baby who dies shortly after birth.
An infected baby may be born without signs or symptoms of disease.
Untreated babies may become developmentally delayed, have seizures, or die.
How do you diagnose Syphilis?
---------------------------------------
1. dark-field microscope: examining material from a chancre using this microscope.
If syphilis bacteria are present in the sore, they will show up when observed through the microscope.
2.A blood test for syphilis antibodies is accurate, safe, and inexpensive. There will be some antibodies in the blood for months even when the disease has been successfully treated.
Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, every pregnant woman should have a blood test for syphilis.
What is the treatment of Syphilis?
-----------------------------------------
Syphilis is easy to cure in its early stages.
Treatment with intramuscular injection of penicillin can kill the organism that causes syphilis.
If you're allergic to penicillin, other antibiotics such as erythromycin will kill the syphilis bacterium.
Treatment however will not repair damage already done.
Left untreated, the disease can lead to serious complications or death.
Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed.
Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.
Even if you were treated for syphilis during your pregnancy, your newborn child should receive antibiotic treatment.
To make sure you're responding to the usual dosage of penicillin, the doctor likely will want you to have periodic blood tests.
Blood test may remain positive up to 18 months even after successful treatment of syphilis.
Having syphilis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.
How do you prevent Syphilis?
---------------------------
The surest way to avoid transmission of sexually transmitted diseases, including syphilis, is to 1.abstain from sexual contact
2.in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
3.Avoiding alcohol and drug use may also help prevent transmission of syphilis because these activities may lead to risky sexual behavior.
4.Correct and consistent use of latex condoms can reduce the risk of syphilis only when the infected area or site of potential exposure is protected.
5.Complications from syphilis such as neurosyphilis are rare because of better diagnosis and treatment
A Simple Guide to Candidiasis
A Simple Guide to Candidiasis
------------------------------------
What is Candidiasis ?
-------------------------
Candidiasis is caused usually by the fungus Candida albicans.
Other Candida species or yeasts are also responsible.
What are the causes of Candidiasis ?
-------------------------------------------
1. Broad spectrum Antibiotic therapy kills off normal bacterial flora, resulting in invasion of fungi or yeasts
2. Diabetes mellitus - the high sugar content in the blood and vagina lining are conducive to fungal or yeast infection
3. Steroid or immunosuppressive drugs suppress the immune response to bacterial and fungal infection.
What is the symptoms of Candidiasis ?
----------------------------------------------
30% of patients do not have any symptoms.
The rest have symptoms like:
1. pruritus,
2.vaginal soreness,
3.dyspareunia,
4.external dysuria, and
5.abnormal white transparent vaginal discharge with heavy odour.
About 75% of women will have at least one episode of Candidiasis, and 45% may have two or more episodes.
How do you diagnose Candidiasis ?
------------------------------------------
A diagnosis of Candida vaginitis is made clinically by the presence of:
1.external dysuria
2.vulvar pruritis, pain, swelling, and redness.
3. vulvar edema, fissures, excoriations,
4.thick curdy vaginal discharge.
The diagnosis is confirmed by
1) a Gram stain of vaginal discharge showing the presence of yeasts
2) a vaginal swab for culture shows the presence of a yeast species.
What is the treatment of Candidiasis ?
---------------------------------------------
Short-course intravaginal antifungal pessaries effectively treat uncomplicated Candidiasis .
The topically applied imidazole drugs are more effective than nystatin.
90% of patients are usually cured.
Oral Agent such as Fluconazole 150 mg may be given in one tablet in single dose.
Patients should be instructed to return for follow-up visits only if symptoms persist.
Candidiasis is not usually acquired through sexual intercourse.
A minority of male sex partners might have balanitis, which is characterized by itchy red areas on the glans of the penis.
These men benefit from treatment with topical antifungal agents to relieve symptoms.
Topical agents usually do cause any systemic side effects although in some people local burning or irritation might occur.
Oral agents sometimes cause nausea, abdominal pain, and headache.
Some abnormal elevations of liver enzymes may occur with treatment with the oral azoles.
What are the complications of Candidiasis?
---------------------------------------------------
1.Recurring Candidiasis:A small percentage of women (<5%)>.
The majority of women with recurring Candidiasis have no apparent predisposing or underlying conditions.
Vaginal cultures should be obtained from these patients to confirm the clinical diagnosis and to identify unusual species, including nonalbicans species, particularly Candida glabrata
Conventional antimycotic therapies are not as effective against these species as against C. albicans.
A longer duration of initial therapy is necessary to attempt mycologic remission before initiating a maintenance antifungal regimen:
Oral fluconazole (i.e., 100-mg, 150-mg, or 200-mg dose) weekly for 6 months
topical clotrimazole 200 mg twice a week,
clotrimazole (500-mg dose vaginal pessaries once weekly)
2.Women with underlying debilitating medical conditions (e.g., uncontrolled diabetes or on corticosteroid treatment) do not respond as well to short-term therapies.
The underlying diseases should be treated and more prolonged (i.e., 7–14 days) conventional antimycotic treatment is necessary.
3.During pregnancy, Candidiasis is quite common.
Only topical azole therapies, applied for 7 days, are recommended for use .
Oral treatment is contraindicated because of risks of deformity in the foetus.
------------------------------------
What is Candidiasis ?
-------------------------
Candidiasis is caused usually by the fungus Candida albicans.
Other Candida species or yeasts are also responsible.
What are the causes of Candidiasis ?
-------------------------------------------
1. Broad spectrum Antibiotic therapy kills off normal bacterial flora, resulting in invasion of fungi or yeasts
2. Diabetes mellitus - the high sugar content in the blood and vagina lining are conducive to fungal or yeast infection
3. Steroid or immunosuppressive drugs suppress the immune response to bacterial and fungal infection.
What is the symptoms of Candidiasis ?
----------------------------------------------
30% of patients do not have any symptoms.
The rest have symptoms like:
1. pruritus,
2.vaginal soreness,
3.dyspareunia,
4.external dysuria, and
5.abnormal white transparent vaginal discharge with heavy odour.
About 75% of women will have at least one episode of Candidiasis, and 45% may have two or more episodes.
How do you diagnose Candidiasis ?
------------------------------------------
A diagnosis of Candida vaginitis is made clinically by the presence of:
1.external dysuria
2.vulvar pruritis, pain, swelling, and redness.
3. vulvar edema, fissures, excoriations,
4.thick curdy vaginal discharge.
The diagnosis is confirmed by
1) a Gram stain of vaginal discharge showing the presence of yeasts
2) a vaginal swab for culture shows the presence of a yeast species.
What is the treatment of Candidiasis ?
---------------------------------------------
Short-course intravaginal antifungal pessaries effectively treat uncomplicated Candidiasis .
The topically applied imidazole drugs are more effective than nystatin.
90% of patients are usually cured.
Oral Agent such as Fluconazole 150 mg may be given in one tablet in single dose.
Patients should be instructed to return for follow-up visits only if symptoms persist.
Candidiasis is not usually acquired through sexual intercourse.
A minority of male sex partners might have balanitis, which is characterized by itchy red areas on the glans of the penis.
These men benefit from treatment with topical antifungal agents to relieve symptoms.
Topical agents usually do cause any systemic side effects although in some people local burning or irritation might occur.
Oral agents sometimes cause nausea, abdominal pain, and headache.
Some abnormal elevations of liver enzymes may occur with treatment with the oral azoles.
What are the complications of Candidiasis?
---------------------------------------------------
1.Recurring Candidiasis:A small percentage of women (<5%)>.
The majority of women with recurring Candidiasis have no apparent predisposing or underlying conditions.
Vaginal cultures should be obtained from these patients to confirm the clinical diagnosis and to identify unusual species, including nonalbicans species, particularly Candida glabrata
Conventional antimycotic therapies are not as effective against these species as against C. albicans.
A longer duration of initial therapy is necessary to attempt mycologic remission before initiating a maintenance antifungal regimen:
Oral fluconazole (i.e., 100-mg, 150-mg, or 200-mg dose) weekly for 6 months
topical clotrimazole 200 mg twice a week,
clotrimazole (500-mg dose vaginal pessaries once weekly)
2.Women with underlying debilitating medical conditions (e.g., uncontrolled diabetes or on corticosteroid treatment) do not respond as well to short-term therapies.
The underlying diseases should be treated and more prolonged (i.e., 7–14 days) conventional antimycotic treatment is necessary.
3.During pregnancy, Candidiasis is quite common.
Only topical azole therapies, applied for 7 days, are recommended for use .
Oral treatment is contraindicated because of risks of deformity in the foetus.
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