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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To design and apply a multi-method promotional package for enhancing awareness and knowledge on STD and AIDS among ITI trainees, and evaluate its impact, an intervention study, using pre and post assessment of the subjects for comparison was carried out. The study was carried out in the Industrial Training Institute (ITI), in a resettlement colony of Delhi. Urethral/vaginal discharge, genital ulcer and pain on micturition were identified as symptoms of STD by a significantly higher number of respondents in the post package sample. A sizable number of subjects included inguinal swelling and lower abdominal pain also as STD symptoms. The IEC intervention showed a significant improvement in knowledge about all four major routes of transmission of HIV/AIDS. Using condoms and avoiding sex with Commercial Sex Workers were reported as measures to prevent STD/AIDS by a significantly higher number of subjects after the intervention. A sizable number of subjects also included other measures (using safe blood/not sharing needles etc.) as well. There was a significant decline in the subjects preferring self treatment or treatment from a chemist shop in case one suffered with an STD. A significant increase was observed in those preferring treatment from govt. facilities or private allopathic doctors. However, the intervention did not seem to result in preference for alternative systems of medicine. The study demonstrated that exposure to intensive promotional intervention, even for a brief period can significantly raise awareness and knowledge of young people even on sensitive topics like STD and AIDS.
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PMID:Impact of a multi-method promotional package on awareness and knowledge about STD and AIDS among the trainees of an industrial training institute in a resettlement colony of Delhi, India. 1093 96

A 13-year-old girl with a history of 4 months of perianal skin lesions is described. Physical examination revealed three 0.5 I 1-cm red, swollen, fleshy, skin tags extending from the perianal area to the perineum (Fig. 1). The patient reported intermittent fever, diarrhea, and abdominal pain, and her body weight was below the third percentile for her age. Laboratory studies showed an erythrocyte sedimentation rate of 101 mm/h; hematocrit of 26%; white blood cell count of 9800/mm3; serum iron of 15 mg/L (normal value (NV), 60-160 mg/L); ferritin of 43.4 microg/L (NV, 12-150 microg/L); transferrin of 203 mg/100 mL (NV, 200-400 mg/100 mL); transferrin saturation of 6% (NV, 20-50%); hypoalbuminemia; negative purified protein derivative (PPD), cytomegalovirus (CMV), human immunodeficiency virus (HIV), venereal disease research laboratory (VDRL), and antinuclear antibody tests; and Toxoplasma titers of 1/16, Van de Kamer 1.67 g/day. A barium examination revealed marked irregularity of the descending colon, and a colonoscopy showed uneven areas of mucosal edema and pseudopolyps in the transverse and descending colon, associated with irregular thickening and stenosis. Histopathologically, large intestine and skin lesions consisted of noncaseating epithelioid and giant cell granulomas (Fig. 2). Cultures for acid-fast bacilli and fungi were negative, and under polarized light no foreign bodies were seen. Treatment with metronidazole (250 mg three times a day), prednisone (0.5 mg/kg/day), and acetylsalicylic acid (75 mg/kg/day) was moderately effective. Vitamin, folic acid, and iron supplements were also added.
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PMID:Perianal Crohn's disease. 1097 32

The objective of the study was to determine the clinical manifestations and diagnostic criteria used to diagnose presumptive pelvic inflammatory disease (PID) at the Sydney Sexual Health Centre (SSHC). The study was a retrospective, case-note review of all women diagnosed with presumptive PID between April 1991 and December 1997. Seven hundred and thirteen women were included. The commonest recorded symptoms were vaginal discharge (68%), lower abdominal pain (65%) and dyspareunia (57%), while adnexal tenderness (83%), cervical motion tenderness (75%) and cervicitis (56%) were the most frequently recorded examination findings. Sixty-two per cent were prescribed doxycycline and metronidazole. The recording of signs and symptoms in women with presumptive PID was poor and only 22% met the current Centers for Disease Control (CDC) diagnostic criteria. It is likely that PID is over diagnosed in this group of women. This may lead to under diagnosis of other conditions causing pelvic pain and may be detrimental to reproductive health.
Int J STD AIDS 2000 Aug
PMID:Diagnosing PID--getting the balance right. 1099 Mar 40

As many as 85% of women with untreated pelvic inflammatory disease (PID) become infertile, almost 20% endure chronic pelvic pain which can be so severe that it prevents women from doing their daily tasks, and the permanent scarring and narrowing of the fallopian tubes caused by the condition increases a woman's risk of having a life-threatening ectopic pregnancy by 7- to 10-fold. Since sexually transmitted diseases (STD) cause most cases of PID, the prompt and effective treatment of STDs as well as preventing future cases can greatly reduce the incidence of PID and its consequences. Women frequently first seek help in primary health care facilities for their ailments. Health care providers at such facilities, however, often erroneously assume that laboratory tests are needed to diagnose and treat women with STDs or lower abdominal pain. Valuable time is lost when such providers refer women unnecessarily to hospitals or STD clinics for diagnosis and treatment. Providers should instead diagnose and treat patients on the basis of groups of symptoms, or syndromes, rather than for specific STDs. This syndromic approach may require treatment for several STDs concurrently since several STDs may cause a particular syndrome. Some guidelines are presented for diagnosing and treating PID. Finally, providing treatment at the primary care level also allows the opportunity for the attending practitioners to encourage monogamy and provide clients with condoms for the prevention of future disease.
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PMID:Health care providers can prevent and treat PID. 1217 15

Management of sexually transmitted diseases (STDs) requires not only diagnosis and treatment but also setting up a health education program and conducting follow-up. The health provider needs tactfully and respectfully to ask each patient about the symptoms responsible for his/her seeking health care. In taking this case history, the provider should use words understandable by the patient. As soon as possible and after having explained what is going to happen and obtaining informed consent, the provider must perform a physical examination of the genitals, the anal region, and the groin to look for STD signs (e.g., habitual genital discharge). After having determined the current STD symptoms, the provider needs to follow the appropriate algorithms (decision making tools) in order to prescribe treatment while emphasizing the need for the patient to correctly follow treatment. Next, the provider needs clearly to explain how STDs are transmitted, the importance of treatment of the partner, and ways to prevent STDs (e.g., condom use). The provider needs to ask the patient to return in seven days for a follow-up consultation. During the follow-up visit, the provider needs to ask about change in symptoms, sexual activity, and condom use or nonuse and to perform a physical examination. The article provides specific algorithms and treatment options for the major STD signs and symptoms: genital ulcers, penal discharge, abdominal pain, vaginal discharge (i.e., leucorrhea). For example, if a man has genital discharge, gonorrhea or chlamydia may be responsible. The type of discharge helps identify the etiologic agent: gonorrhea tends to produce a yellow discharge that resembles pus while chlamydia produces a less thick discharge. Recommended antibiotics for gonorrhea are cefixime, ceftriaxone, ciprofloxacine (contraindicated for pregnant women), spectinomycin, kanamycin, and trimethroprim/sulfamethoxazole. Recommended drugs for chlamydia are doxycycline, tetracycline, and erythromycin.
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PMID:[Management of STDS at the primary care level. Recommendations for STD treatment]. 1229 20

Each year 250 million new cases of sexually transmitted diseases (STDs) have the potential to cause pelvic inflammatory disease, infertility, blindness, and death. Sometimes the onset of these STDs is symptomless, but the following conditions indicate the presence of an STD: genital discharge, sores, wounds, or blisters; swollen glands in the groin; cauliflower-like growths on the genitals; skin rash; lower abdominal pain in females; painful swelling in the testicles; alopecia; discharge from the eyes; and pain during intercourse. The 5 most common STDs which can be cured with antibiotics are chancroid, chlamydial infection, gonorrhea, syphilis, and trichomoniasis. By the end of 1994 in Uganda, 390 primary health units will be available for STD treatment, and most health workers will be trained in STD patient management. Since patients will receive the minimum amount of treatment needed to cure the STD, they will be well advised to use the drugs provided. Notification of all recent sex partners is also essential, and sex partners should be evaluated even if they are asymptomatic. Patients are advised to engage in safe sex behavior, including remaining faithful to a monogamous relationship and using condoms, and to seek medical advice if they develop STD symptoms or are exposed to STD. The AIDS virus is also transmitted through sexual intercourse as well as through blood transfusions, from mother to child, and through the use of contaminated needles. HIV infection progresses from a stage where it cannot be detected to an asymptomatic stage to a symptomatic stage. Chronic diarrhea, fever, and weight loss are the major symptoms. There is no treatment for HIV infection, but zidovudine (AZT) can delay progress of the disease. The most important treatment available is counseling and understanding. The Uganda AIDS Commission works to control the disease through education, treatment of STDs, provision of safe blood for transfusion, monitoring, counseling patients, and promoting research. The primary objective in the care of AIDS patients is to improve the quality of their life as much as possible.
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PMID:Telling signs and symptoms. 1231 60

Patients with sexually transmitted diseases (STDs) in developing countries are often untreated for long periods of time or receive ineffective treatment, producing complications that can lead to infertility, blindness, and even death. In addition, there is growing research evidence that people with bacterial or viral STDs are more likely to acquire--and perhaps transmit--the human immunodeficiency virus (HIV). STD control programs in developing countries must be reorganized to include: 1) good management of patients with STDs and their contacts, 2) case finding for syphilis in the antenatal population, 3) screenings and case findings for gonorrhea in high-risk groups, and 4) systematic prophylaxis for ophthalmia neonatorum in newborns. Since diagnosis before treatment is problematic in rural areas, the World Health Organization recommends simple treatment protocols based on the most common STD symptoms--urethral discharge; gynecological complaints such as vaginal discharge, low abdominal pain, or dysuria; genital ulceration; and inguinal bubo, a swelling of the lymph nodes in the groin. Other components of this approach include standardized treatment, contact tracing and treatment, health education targeted at high-risk groups, follow-up and case referral where necessary, and the collection of simple statistics on treatment efficacy and STD epidemiology. The incidence of STDs in developing countries is steadily increasing as a result of urbanization, increased numbers of young people, and delayed age at marriage. However, this situation can be combatted through application of treatment protocols, technological advances, improvements in the health care delivery system, and awareness on the part of policy makers of the seriousness of the STD problem.
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PMID:Management of sexually transmitted diseases. 1234 18

Some 250 million cases of sexually transmitted disease (STD) occur each year, and in some countries 1 or even 2 women in every 10 are infected with an STD. STDs are likely to reach an advanced stage before women notice them. The consequences of STDs are devastating, according to a report by the Population Information Program of the Johns Hopkins School of Public Health, and they include stillbirths, blinding eye infections in the newborn, chronic female abdominal pain, ectopic pregnancy, and infertility. There are social consequences for women such as divorce, and husbands may abandon infertile wives. Gonorrhea and chlamydia can cause both severe inflammation of the pelvis with acute pain and possible infertility. Pelvic inflammatory disease can permanently scar the fallopian tubes, increasing the risk of ectopic pregnancy, which can be fatal when the fallopian tube ruptures. Babies born to mothers with gonorrhea and chlamydia are likely to develop eye infections that may make them blind. Chlamydia infection in pregnant women may also cause premature rupture of the membranes, sepsis, and the death of premature neonate. Infection may spread to the lungs of newborns, leading to chlamydial pneumonia. Syphilis can cause spontaneous abortion, stillbirth, neonatal death, or congenital syphilis in the infant. Trichomoniasis and herpes can also be transmitted from mother to fetus. And infection with an STD increases the risk of infection with the human immunodeficiency virus (HIV). The World Health Organization (WHO) recommends that prenatal care should always include checks for STDs. A WHO Technical Working Group on Care of Mother and Baby has stressed the importance of detecting and treating STDs in pregnant women. The working group urged training of health workers to distinguish between STDs and other infections. The group, which met July 5-9, 1993, outlined health center strategies for prevention and treatment.
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PMID:STDs infect 250 million a year. 1234

Cost concerns as well as constraints of time, resources, and access to treatment frustrate and even impede the use of the etiological and clinical approaches to diagnosing and treating sexually transmitted diseases (STDs) in Africa. Syndromic case management, an alternative to these approaches, refers to the ability to identify and treat a syndrome caused by a STD, with minimal or no requirement for laboratory support. A syndrome can be defined as a combination of symptoms or complaints, with signs detected during clinical examination. The most important STD-related syndromes include urethral discharge in men, vaginal discharge in women, genital ulcer in men and women, lower abdominal pain, inguinal bubo (swelling), balanitis/balanoposthitis in men, and scrotal swelling. The aim of syndromic management is to identify a syndrome and treat it accordingly with combination therapy which will cover the main pathogens that cause it. The World Health Organization (WHO) strongly encourages the adoption of the syndromic management of STDs, and it has developed a series of flow-charts or clinical algorithms for the standardized management of STD cases. These general guidelines need to be adapted for local conditions in order to maximize their specificity and effectiveness. The advantages and disadvantages of syndromic case management, as well as the implementation of the strategy, are considered.
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PMID:Syndromic case management of STDs in Africa. 1234 89

Sexually transmitted diseases (STD) are quite common and observed more frequently in teens. The adolescents represent a group at particular risk for STD due to biological, sociocultural and psychological factors. Undectected infections may lead to unwanted sequelae, including pelvic inflammatory disease, chronic abdominal pain, tubal scarring and increased risk of ectopic pregnancy. This paper deals with infections by Candida albicans, Chlamidia tracomatis, Neisseria gonorrheae, Gardnerella vaginalis, Treponema pallidum, Tricomonas vaginalis, Herpes simplex, Papilloma virus. In regard to gonorrhea, chlamydia, syphilis and papilloma virus, the expectation is that improved detection will decrease sequelae by early diagnosis and treatment. Prevention programs (information, use of hormonal contraception associated with condom use) and improved access to STD diagnosis and treatment services are useful to reduce the incidence of STD among young people.
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PMID:[Sexually transmitted infections]. 1238 42


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