Friday, 18 November 2011

Gonorrhoea-Sexually Transmitted Disease/A summarized preview

One of the commonest STI ,caused by Neisseria gonorrhoeae.
This infection can spread from any form of sexual habit be it oral or vaginal or anal from the infected person.Prevalence of this infection is same in both genders,but in females particularly this infection severely effects their reproductive system and can even infect eyes.
Clinical Gonorrhoea Symptoms:- MALE
        • Burning,pain and itching while passing urine.
        • Abnormal colored and foul smelling discharge from penis.
        • Swollen or redness over penis opening.
        • Tenderness or swollen testicals.
        • Increased frequency of urination.
        • Sore and painful throat.
 Clinical Gonorrhoea Symptoms:-FEMALE
        • Burning,pain and itching while passing urine.
        • Increased frequency of urination.
        • Abnormal colored and foul smelling vaginal discharge .
        • Fever.
        • Pain abdomen specifically lower abdomen.
        • Painful Intercourse.
        • Sore Throat.
Gonorrhoea leads to:-
        • Infertility.
        • Pelvic Inflammatory Disease.
        • Salpingitis.
        • Infection to fetus during pregnancy or newborn at the time of birth.
        • Joint pain and infections.
        • Infection leading to damage hart valve.
        • Meningitis.
Gonorrhoea Prevention and Treatment :- Please refer this link on PID.

Wednesday, 16 November 2011

Pelvic Inflammatory Disease(P.I.D)-A summarized preview.

What is Pelvic Inflammatory Disease.
PID refers to female diaspora,in general.The usual infection starts from cervix/vagina of females involves female reproductive system(Endometrium and/or fallopian tubes)and may even extend further involving different organs/systems of stomach and near by areas.PID is sometimes caused due to other inflammatory foci,like inflammation in adjacent areas.,eg appendicitis or due to hematological manifestations eg.Tuberculosis or due to some other infections.Intrauterine infections are primarily due to STIs’ or secondary due to surgical procedures.
Pelvic Inflammatory Disease(PID) is caused primarily by N.gonorrhoeae which causes gonorrhea and sometimes by Chlamydia. trachomatis which is linked to be a causative factor for Human T-cell Lymphotropic virus Type-1.There are few other organisms also but I don’t think mentioning them over here is worth as my main intention is to make this blog for general public awareness and discuss about myths and misconceptions and not for medicos for whom tons of medical material can be found everywhere.

Clinical Signs and Symptoms for Pelvic Inflammatory Disease:-
  • Fever.
  • Abdominal tenderness.
  • C reactive protein levels are increased.
  • Abnormal vaginal bleeding.
  • Yellowish vaginal discharge.
  • Ano-rectal pain or bleeding-though rarely..
Main signs and symptoms to remember for PID risk:-
    • Sexually active young females and even other sexually active females with prolonged pain abdomen where no other cause is found.
    • Pelvic tenderness on manual pelvic examination.
    • Cervical motion tenderness.
    • Incidence of lower genital tract infections.
PID leads to:-
    • Infertility.
    • Increased risk of ectopic pregnancy and hysterectomy.
    • Salpingitis,etc…
Prevention of Pelvic Inflammatory Disease:-
    • Regular and periodic screening leads to early detection even in symptom free patient. One should be faithful,avoid multiple partners and casual encounters. 
Treatment of Pelvic Inflammatory Disease:-
    • There are two goals for treatment :first is to treat the patient and secondly taking detailed history of sexual behavior from the patient and than locating each and every partner for treatment and curtailing spread of infections.Health providers in US are bound by the law to inform their respective health boards regarding gonorrhoea and clamydia diagnosed individual,law makes sure that patient turns for regular and prompt follow up and all its partners are located and treated.
    • Regular and prompt Anti-biotic coverage.(Names of Antibiotics are not provided in fear of self-medication).
    • Rarely Surgical intervention.
    I’ve tried to summarize what PID is,avoiding many confusing and difficult terms,for any further clarification either drop a mail to me or meet your local health professional.

Tuesday, 15 November 2011

Sexually Transmitted Diseases/Sexually Transmitted Infections-Myths and Realities.

Recently, I received a mail from one Julia of Florida,age 40 years,asking me some queries regarding Pelvic Inflammatory disease(a kind of a syndrome related to STI).I was surprised  about the nature of questions which were asked,showed the extent of sheer ignorance and myths which may be prevailing in a civilized world like US,prompted me to leave other  posts and concentrate on the much burning and important topic-STD.or better known these days as Sexually Transmitted Infections(STI) or Venereal Disease ,over the next few weeks I will try to write as many possible myths and  realities about different infections .Curiously I tried to search about STI’s on different health and medical sites but most of them seem to have out dated material loaded or techniques which are not used these days.It is invariably not possible for me to write about each and every venereal infection separately but with best of my knowledge and resources available to me I have tried to compile about the most common myths.
STIs’ can be broadly classified into three types,which again are divided into three types,Bacterial,Viral and Others(Fungi,protozoan)
    • Infections primarily through sexual route.
    • Infections but not predominantly through other  routes,but sexual is a possible route.                                              
    • Infections through Oro-fecal  route,In gay communities.                                                                                           
      • SYNDROME
      • AIDS
      • Urethritis: males:-
            • Epididymitis
      • Lower genital tract infections: females:-
            • Cystitis/urethritis
            • Mucopurulent cervicitis
            • Vulvitis
            • Vulvovaginitis
            • Bacterial vaginosis (BV)
            • Acute pelvic inflammatory disease
            • Ulcerative lesions of the genitalia
            • Complications of pregnancy/puerperium
            • Proctitis
            • Proctocolitis or enterocolitis
            • Enteritis
            • Acute arthritis with urogenital
            • infection or viremia
            • Genital and anal warts
            • Mononucleosis syndrome
      • Infertility
      • Intestinal infections
      • Hepatitis
      • Neoplasias
      • Squamous cell dysplasias and
        cancers of the cervix, anus, vulva,
        vagina, or penis
      • Kaposi’s sarcoma, body-cavity
      • T-cell leukemia
      • Hepatocellular carcinoma
      • Tropical spastic paraparesis
      • Scabies
      • Pubic lice
      • I’ve compiled this list to make people understand that what all names are STIs’.
      • With inputs from Harrison's Medicine.

Here I will write about  most common myths pertaining practically to all STIs’ but before doing so pals ,answer the following very nice effective questionnaire,every one should ask oneself.
In order to provide the best care for you today and to
understand your risk for certain infections, it is necessary
for us to talk about your sexual behavior.
Screening Questions:
(1) Do you have any reason to think you might have a
sexually transmitted disease? If so, what reason?
(2) For all adolescents <18 years old: Have you begun
having any kind of sex yet?
STD History:
(3) Have you ever had any sexually transmitted diseases
or any genital infections? If so, which ones?
Sexual Preference:
(4) Have you had sex with men, women, or both?
Injection Drug Use:
(5) Have you ever injected yourself (“shot up”) with
drugs? (If yes, have you ever shared needles or
injection equipment?)
(6) Have you ever had sex with a gay or bisexual man or
with anyone who had ever injected drugs?
Characteristics of Partner(s):
(7) Has your sex partner(s) had any sexually transmitted
infections? If so, which ones?
STD Symptoms Checklist:
(8) Have you recently developed any of these symptoms?
For Men For Women
(a) Discharge of pus (a) Abnormal vaginal discharge
(drip) from the penis (increased amount,
(b) Genital sores (ulcers) abnormal odor, abnormal
or rash yellow color)
(b) Genital sores (ulcers),
rash, or itching
Sexual Practices, Past 2 Months (for patients answering
yes to any of the above questions, to guide examination
and testing):
(9) Now I’d like to ask what parts of your body may have
been sexually exposed to an STD (e.g., your penis,
mouth, vagina, anus)?
Query About Interest in STD Screening Tests (for
patients answering no to all of the above questions):
(10) Would you like to be tested for HIV or any
other STDs today? (If yes, clinician can explore
which STD and why.)
Source: Adapted from JR Curtis, KK Holmes, in KK Holmes et al (eds):
Sexually Transmitted Diseases, 3d ed. New York, McGraw-Hill, 1999.

Myths and Realities.
    1. I will not get infected with occasional change of partner.
      • A myth,sleeping with changed partner even once can infect you even though he /she appears to be a healthy lad,in my clinical experience generally people are reluctant even before medical professionals to accept about STI’s leave aside discussing with partners or many a times people aren’t aware that they are infected due to lack of symptoms,if infection is in early stage .While few infections like HIV have incubation period which may even last for years ,making one just a carrier and  infect others.
    2. I will not get infected with use of condoms.
      • True to some extent that it is the best possible barrier available today but if used with a infected person regularly can give infection in event of a mal function,leakage of bodily fluids,rupture,etc.
    3. I am already infected with one STI so I won’t be infected with other type.
      • This is one of biggest myths about STIs’,as written above STIs’ can be viral ,bacterial ,fungal,etc. meaning different kind of micro organisms are involved,so therefore an individual can suffer from two even three-four STIs’ at the same time.
    4. I am pregnant so won’t get any STI .
      • This is one of the myth, I don’t understand that even highly educated women around believe,beautiful mothers !!!this is a complete non sense,rather any STI can create  havoc to mother as well as fetus, adding to it, many medicine used to treat STI may have a cascading effect on  fetus which may even surface after few years of child birth.
    5. HIV cannot be cured so do other STIs’.
      • Yes HIV cannot be fully cured,but with proper treatment and care can be controlled to give patient a prolonged life span.
      • Regarding other STIs’ bacterial ones can be fully cured if diagnosed early and treated properly,few viral STI’s even have vaccines while other respond to anti-retroviral therapy.
    6. I will not get infected by using oral or anal route.
      • No,any minor injuries or cut on skin will make micro organisms to penetrate into oral cavity or anus or genitals.
      • Few STI’s like Herpes can spread just by  rubbing or skin to skin contact or kissing with the infected person.
    7. Contraceptive pills provide some protection against STIs’.
      • A complete myth,these pills are effective in controlling pregnancies,they have no roll whatsoever regarding STIs’,Condom is the best effective measure against STI.
    8. Circumcision means no STIs’.
      • A myth again ,this notion prevailed so strongly for years especially in African community that even people in Western world circumcised,but lot of studies over the years have proved this absolutely wrong.
      • In fact ,many researches have proved that circumcision should be done when medically justified,otherwise it is like giving yourself pain and agony with no use at all.
      • Please note I am not against religions/ethnic groups practicing circumcision but what ever I have mentioned is quoted from best researches available till date.

Sunday, 6 November 2011

Child abuse myths and realities

Parents/guardian/wardens-this is a burning topic these days,prevalence of child abuse has increased many times,over the years.Data collected from different sources show,in 60-70% cases,people who are near and dear to the child are actually involved.
I've found a very nice video on you tube made by some Indian probably,which should be shown to each and every child.
Click on this link-   child abuse-myths n realities

Headache-Myths and Realities.

“I’ve been getting headache so bad that I cry often.It hurts everywhere on my top,back left side,right side.If this doesn’t improve I will kill myself one day”.This pain generally hurts me in early morning hours,remains their for few hours and then vanishes but it hurts and hurts very badly. Sound’s familiar ,yes this is a fact ,you must have heard people uttering these words……….
Headache or Cephalalgia(medical term)
· Broadly can be divided into three groups.

  • Primary.
  • Secondary.
  • Cranial neuralgias.
  • Primary :-
    • Migraine.
    • Cluster.
    • Tension.
    • Trigeminal Autonomic.
    • Sexual activity related (coital headache).
    • Few others
    • Secondary:-
        • Due to trauma leading to head/neck injury.
        • Some tumor,cyst,etc.
    • Cranial neuralgias.
        • Facial pain and other headache.

    I will try to explain about difference between types of headache in my coming posts.

    Headache-Myths and Realities.
  1. All Headache are same.
    • This is insane,as written above ,headaches are never same ,cause,duration,intensity,onset time may vary amongst individuals,as a result treatment also varies.
  2. Tumors are the main cause for headache.
    • A strange fact that tumors or even many serious disorders of brain rarely causes headaches,every second or third person suffers from headache in US,but only few thousands are diagnosed with Tumors.
  3. Caffeine is the remedy for all types of headache.
    • Low doses of caffeine might help in relieving certain types of headache or decreases intensity in many anecdotal reports but till date has not been subjected to any controlled study,prolonged and continues use of caffeine and related medication can make one dependent.
  4. Botox shots are for beauty treatments only.
    • No not at all,since few years botox shots are being popularly use to treat severe migraine but then like all other medication,Botox shots are not suitable for everyone.
  5. Problem lies where your pain is.
    • This statement does not hold any significance,your problem can be distance away,like severe headache in the frontal area can be attributed to falling eye sight numbers.
    • Brain has no pain receptors,so it has no perception for pain,but ironically it is the brain which make us feel the pain in different part of body,reason behind is that though brain has no receptors,bones,skin other tissues around the brain has pain receptors ,so any disturbance in their area due to any cause leads to headache.
  6. Sleep has no role in Headache.
    • No ,it has.Lack of sleep,fatigue may cause severe headache,moreover excessive sleep can also trigger headache in few.
  7. N.B, Any onset of sudden and severe headache with or without dizziness should be dealt seriously,it may be the beginning of some acute underlying pathology,like,Trans Ischemic attack,Sub Arachnoid Hemorrhage,etc.