Bacterial vaginosis by dr alka mukherjee DR APURVA MUKHERJEE nagpur m.s.alka mukherjee
Bacterial vaginosis is a type of vaginal inflammation caused by the overgrowth of bacteria naturally found in the vagina, which upsets the natural balance. Women in their reproductive years are most likely to get bacterial vaginosis, but it can affect women of any age. Bacterial overgrowth in the vagina.
Bacterial vaginosis tends to affect women of childbearing age. Activities such as unprotected sexual intercourse or frequent douching can increase a person's risk.
In some cases, there are no symptoms. In other cases, there may be abnormal vaginal discharge, itching or odour. BV can clear up on its own.
Treatment can include prescription cream, gel or medication. Recurrence within three to 12 months is common, requiring additional treatment.
Very common
More than 10 million cases per year (India)
Treatable by a medical professional
Short-term: resolves within days to weeks
Requires a medical diagnosis
Lab tests or imaging often require
Yeast infections are generally caused by an organism called Candida albicans. Natural cures are simple, less expensive, and by far the most important point, they actually work. Get few tips for avoiding this disease with ease.
http://www.yeastinfectionheal.com/
Yeast infections are generally caused by an organism called Candida albicans. Natural cures are simple, less expensive, and by far the most important point, they actually work. Get few tips for avoiding this disease with ease.
http://www.yeastinfectionheal.com/
Bacterial vaginosis by dr alka mukherjee DR APURVA MUKHERJEE nagpur m.s.alka mukherjee
Bacterial vaginosis is a type of vaginal inflammation caused by the overgrowth of bacteria naturally found in the vagina, which upsets the natural balance. Women in their reproductive years are most likely to get bacterial vaginosis, but it can affect women of any age. Bacterial overgrowth in the vagina.
Bacterial vaginosis tends to affect women of childbearing age. Activities such as unprotected sexual intercourse or frequent douching can increase a person's risk.
In some cases, there are no symptoms. In other cases, there may be abnormal vaginal discharge, itching or odour. BV can clear up on its own.
Treatment can include prescription cream, gel or medication. Recurrence within three to 12 months is common, requiring additional treatment.
Very common
More than 10 million cases per year (India)
Treatable by a medical professional
Short-term: resolves within days to weeks
Requires a medical diagnosis
Lab tests or imaging often require
Yeast infections are generally caused by an organism called Candida albicans. Natural cures are simple, less expensive, and by far the most important point, they actually work. Get few tips for avoiding this disease with ease.
http://www.yeastinfectionheal.com/
Yeast infections are generally caused by an organism called Candida albicans. Natural cures are simple, less expensive, and by far the most important point, they actually work. Get few tips for avoiding this disease with ease.
http://www.yeastinfectionheal.com/
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
3. BACTERIAL VAGINOSIS
◦ Also called nonspecific vaginitis or Gardnella vaginitis
◦ Alteration of normal vaginal bacterial flora that results in loss of lactobacilli and an
overgrowth of predominantly anaerobic bacteria.
◦ Concentration of anaerobes and G. vaginalis and Mycoplasma hominis, is 100 to
1,000 times higher than in normal women.
◦ Lactobacilli are usually absent.
◦ repeated alkalinization of the vagina, which occurs with frequent sexual
intercourse or use of douches, plays a role.
4. ◦ Increased risk
⁻ pelvic inflammatory disease (PID)
⁻ postabortal PID
⁻ postoperative cuff infections after hysterectomy
⁻ and abnormal cervical cytology
⁻ Pregnant women risk for premature rupture of the membranes, preterm labor
and delivery, chorioamnionitis
⁻ postcesarean endometritis .
In women with BV who are undergoing surgical abortion or hysterectomy,
perioperative treatment with metronidazole eliminates this increased risk
• Hydrogen peroxide–producing lactobacilli disappear, it is difficult
to reestablish normal vaginal flora -recurrence of BV is common
5. A) Normal mature vaginal cells with Döderlein’s lactobacilli.
B) Clue cells with very few Döderlein’s bacilli.
6. DIAGNOSIS-
◦ A fishy vaginal odor, which is particularly noticeable following coitus
◦ vaginal discharge- gray and thinly coat the vaginal walls.
◦ The pH of these secretions is >4.5 (usually 4.7 to 5.7).
◦ Microscopy of the vaginal secretions reveals an increased number of clue cells.
• the “whiff” test -releases a fishy, amine like odor- +
7. ◦ Clinicians who are unable to perform microscopy should use alternative diagnostic
tests such as a
-pH
-amines test card
-detection of G. vaginalis ribosomal RNA
-Gram stain .
◦ Culture of G. vaginalis is not recommended as a diagnostic tool because of its lack
of specificity.
9. ◦ Amsel et al. established clinical criteria for diagnosing BV.
10. ◦ Nugent et al. described a Gram stain scoring system of vaginal smears to
diagnose BV
11.
12. ◦ Ideally, treatment of BV should inhibit anaerobes but not vaginal
lactobacilli.
◦ METRONIDAZOLE-
◦ Excellent activity against anaerobes but poor activity against lactobacilli, is the
drug of choice for the treatment of BV.
◦ Avoid using alcohol during treatment with oral metronidazole and for 24 hours
◦ A dose of 500 mg administered orally twice a day for 7 days should be used.
◦ Metronidazole gel, 0.75%, one applicator (5 g) intravaginally once daily for 5
days, may also be prescribed.
13. ◦ CLINDAMYCIN
◦ Clindamycin ovules, 100 mg, intravaginally once at bedtime for 3 days
◦ Clindamycin bio adhesive cream, 2%, 100 mg intravaginally in a
single dose Clindamycin cream, 2%, one applicator full (5 g)
intravaginally at bedtime for 7 days
◦ Clindamycin, 300 mg, orally twice daily for 7 days
◦ Many clinicians prefer intravaginal treatment to avoid systemic side
effects ( GI upset , unpleasant tasete)
◦ Treatment of the male sexual partner is not recommended
14. TRICHOMONAS VAGINITIS
◦ Caused by -sexually transmitted
-flagellated parasite.
◦ The transmission rate is high (70% of men contract the disease after a
single exposure to an infected woman.)
◦ It is a anaerobe that has the ability to generate hydrogen to combine
with oxygen to create an anaerobic environment.
◦ It often accompanies BV,
15.
16. ◦ Diagnosis –
Trichomonas vaginitis is associated with a
-profuse, purulent, malodorous vaginal discharge
-vulvar pruritus.
-The pH of the vaginal secretions >5.0.
-patchy vaginal erythema and colpitis macularis (“strawberry” cervix) -
present
17. ◦ Microscopy of the secretions
- motile trichomonads
-increased numbers of leukocytes.
-Clue cells may be present (common association with BV)
◦ The whiff test may be positive.
◦ increased risk for postoperative cuff cellulitis following hysterectomy
◦ Pregnant women with trichomonas vaginitis are at increased risk for premature
rupture of the membranes and preterm delivery.
18. TREATMENT:
◦ Metronidazole is the drug of choice for treatment of vaginal trichomoniasis.
- single-dose (2 g orally) / multidose (500 mg twice daily for 7 days) regimen
- The sexual partner should be treated.
- Metronidazole gel, although effective for the treatment of BV, should not be used for
the treatment of vaginal trichomoniasis.
- Women who do not respond to initial therapy
-treated again with metronidazole, 500 mg, twice daily for 7 days.
-If repeated treatment is not effective-treated with a single 2-g dose of
metronidazole once daily for 5 days or tinidazole, 2 g, in a single dose for 5
days.
19. -should be tested for other STDs, particularly Neisseria
gonorrhoeae and Chlamydia trachomatis.
-Serologic testing for syphilis and HIV infection should be
considered.
- Uncommon refractory cases-obtain cultures of the parasite to
determine its susceptibility to metronidazole and tinidazole.
20. VULVOVAGINAL CANDIDIASIS
◦ An estimated 75% of women experience at least one episode of vulvovaginal
candidiasis (VVC) during their lifetimes.
◦ Few are plagued with a chronic, recurrent infection.
◦ Candida albicans is responsible for 85% to 90% of vaginal yeast infections.
◦ Other species of Candida, such as C. glabrata and C. tropicalis, can cause
vulvovaginal symptoms and tend to be resistant to therapy.
21. Candida –
DIMORPHIC FUNGI
-BLASTOSPORES
which are responsible for transmission
and asymptomatic colonization
-MYCELIA
result from blastospore germination
and enhance colonization and facilitate
tissue invasion.
• The extensive areas of pruritus and inflammation often associated with minimal
invasion of the lower genital tract
• A hypersensitivity phenomenon may be responsible for the irritative symptoms
associated with VVC, especially for patients with chronic, recurrent disease.
22.
23. ◦ Predisposing factors-
– antibiotic use
– Pregnancy
– diabetes
◦ Categorize women with VVC -uncomplicated or complicated disease
Uncomplicated Complicated
Sporadic or infrequent in occurrence Recurrent symptoms
Mild to moderate symptoms Severe symptoms
Likely- candida albicans Non albicans candida
Immunocompetent women Immunocompromised – DM, HIV
24. ◦ Diagnosis
The symptoms of VVC consist -
◦ vulvar pruritus
◦ vaginal discharge that typically resembles cottage cheese.
◦ Vaginal soreness, dyspareunia, vulvar burning
◦ External dysuria (“splash” dysuria) -micturition leads to exposure of the
inflamed vulvar and vestibular epithelium to urine.
25. ◦ The whiff test is negative.
◦ A fungal culture is recommended to confirm the diagnosis.
◦ women with a normal physical examination findings and no evidence of fungal
elements disclosed by microscopy are unlikely to have VVC and should not be
empirically treated unless a vaginal yeast culture is positive.
26. TREATMENT
1.Topically applied azole drugs
◦Symptoms usually resolve in 2 to 3 days.
◦Short-course regimens up to 3 days are recommended.
2.The oral antifungal agent
-fluconazole, used in a single 150-mg dose,
-Patients should be advised that their symptoms will persist for 2 to 3 days so
they will not expect additional treatment
27. 3.Women with complicated VVC
-150-mg dose fluconazole given 72 hours after the first dose.
-Patients with complications treated with a more prolonged topical regimen lasting
10 to 14 days.
-Adjunctive treatment with a weak topical steroid, such as 1% hydrocortisone
cream, may be helpful in relieving some of the external irritative symptoms.
28. RECURRENT VULVOVAGINAL CANDIDIASIS
◦ defined as ≥4 episodes / year
◦ Persistent irritative symptoms of the vestibule and vulva.
◦ Burning replaces itching as the prominent symptom in patients with RVVC.
◦ The diagnosis confirmed by direct microscopy of the vaginal secretions and by
fungal culture.
◦ Many of these patients have chronic atopic dermatitis or atrophic vulvovaginitis.
29. ◦ TREATMENT :
-inducing a remission of chronic symptoms with fluconazole (150 mg every 3 days
for three doses).
-Patients should be maintained on a suppressive dose of this agent (fluconazole,
150 mg weekly) for 6 months.
◦ On this regimen, 90% of women with RVVC will remain in remission.
◦ After suppressive therapy, approximately half will remain asymptomatic.
◦ Recurrence will occur in the other half and should prompt reinstitution of suppressive
therapy .
30.
31. DESQUAMATIVE INFLAMMATORY VAGINITIS
◦ Clinical syndrome characterized by
-diffuse exudative vaginitis
-epithelial cell exfoliation
-profuse purulent vaginal discharge
◦ The cause of inflammatory vaginitis is unknown, but Gram stain findings
reveal a relative absence of normal long gram-positive bacilli (lactobacilli) and
their replacement with gram-positive cocci, usually streptococci.
◦ .
32. ◦ Vaginal erythema is present, and there may be an associated vulvar erythema,
vulvovaginal ecchymotic spots, and colpitis macularis.
◦ The pH of the vaginal secretions is >4.5 in these patients .
◦ TREATMENT:
◦ 2% clindamycin cream treatment of choice
33. ATROPHIC VAGINITIS
◦ Deficency of oestrogen.
◦ Women undergoing menopause
◦ secondary to surgical removal of the ovaries,
◦ Develop inflammatory vaginitis, accompanied by an increased, purulent vaginal
discharge.
◦ They may have dyspareunia and postcoital bleeding resulting from atrophy of the
vaginal and vulvar epithelium.
34. ◦ Examination reveals
-atrophy of the external genitalia, along with a loss of the vaginal rugae.
-The vaginal mucosa friable .
-predominance of parabasal epithelial cells
TREATMENT:
◦ Atrophic vaginitis is treated with topical estrogen vaginal cream.
-Use of 1 g of conjugated estrogen cream intravaginally each day for 1 to
2 weeks generally provides relief.
-Maintenance estrogen therapy, either topical or systemic, should be
considered to prevent recurrence of this disorder
38. GONOCOCCAL
VULVOVAGINITIS
◦ Gram-negative intracellular diplococcus -Neisseria gonorrhoea.
◦ The vaginal squamous epithelium is resistant to gonococcal infection.
◦ The gonococci attack the columnar epithelium of glands of Skene, Bartholin,
urethra and its glands, cervix and fallopian tubes.
◦ It ascends in a piggy-back fashion attached to the sperms to reach the fallopian
tubes.
39. Signs and symptoms-
◦ Urinary frequency ,dysuria
◦ dyspareunia, rectal discomfort,
◦ vaginal discharge
◦ pruritus .
◦ Examination –
◦ swollen, painful external genitalia,
◦purulent vaginal discharge
◦erythema surrounding external urinary meatus,
◦opening of the Bartholin’s ducts, vaginitis , endocervicitis.
◦ Late clinical findings: Bartholinitis, Bartholin’s abscess, Bartholin’s cyst, tubo-
ovarian abscess, pyosalpinx, hydrosalpinx and blocked tubes.
◦ End result of chronic pelvic infection - chronic pelvic pain, dysmenorrhoea,
menorrhagia, infertility with fixed retroversion and at times dyspareunia.
40. ◦ DIAGNOSIS
◦ Gram staining of smear prepared from any suspicious discharge.
◦ Culture -Thayer–Martin medium, and McLeod chocolate agar.
◦ Complement fixation tests and PCR staining..
◦ NAAT from urine, endocervical discharge—95% sensitive
◦ Laproscopy- gonococcal and chlamydial infection showing Fitz-Hugh Curtis
syndrome
41. ◦ Treatment –
◦ Injecting cefoxitin 2.0 g IM plus probenecid 1.0 g orally
◦ followed by 14 days treatment with oral cap. Doxycycline100 mg bid for 14 days
or oral cap.
◦ Tetracycline 250 mg qid for 14 days.
Treat the male partner as well
42. CHLAMYDIA
◦ Chlamydial infection is common in young.
◦ transmitted by vaginal and rectal intercourse.
◦ caused by -Chlamydia trachomatis -Gram-negative bacterium,
◦ asymptomatic mostly- vaginal discharge, dysuria and frequency of micturition,
cervicitis.
◦ During pregnancy, abortion, preterm labour and intrauterine growth retardation
(IUGR) may occur.
◦ The cervix is the first site of infection but may spread upwards to develop PID and
spread to the partner and neonate.
◦ it may cause salpingitis and infertility,
43. ◦ Diagnosis
◦ Immunofluorescence tests on smears prepared from urethral and cervical secretion
◦ IgM can be detected -recent infection.
◦ Enzyme-linked immunosorbent assay (ELISA)
◦ Chlamydia is cultured from the cervical tissue in 5–15% of asymptomatic women.
◦ PCR- fast, highly sensitive and specific -‘gold standard’ in the laboratory diagnosis.
◦ Urine for PCR is simple.
44. ◦ Treatment-
◦ Tetracycline 500 mg and clindamycin 500 mg for 14 days are found
effective.
◦ The combination of cefoxitin and ceftriaxone with doxycycline (100 mg bid
for 14 days) or tetracycline is also useful.
◦ During pregnancy, erythromycin or amoxicillin tid or qid is given for 7 days.
◦ Contact tracing, avoidance of sex or barrier contraceptive is necessary to
avoid recurrence.