This document discusses sexually transmitted diseases (STDs) and their epidemiological determinants and clinical presentations. It notes that over 20 pathogens can be spread through intimate sexual contact, including Neisseria gonorrhoeae, Treponema pallidum, Chlamydia trachomatis, herpes simplex virus, HIV, and Trichomonas vaginalis. The highest incidence of STDs is in people aged 20-24 years old. Syndromic management and treatment options are provided for common STDs like gonorrhea, chlamydia, syphilis, and genital herpes. Control of STDs requires initial planning, intervention strategies like screening and contact tracing, support components like STD clinics and
STD is an abbreviated form of Sexually transmitted diseases. The meaning of STD disease is that the disease is imparted to others through sexual contact. Apart from sexual transmission, sexually transmitted diseases are also transferred to other persons in various ways. These are- breastfeeding, sharing of infected needles, etc. There are many diseases under the class of STD, and these can be cured by maintaining proper sexual health and hygiene. The mass awareness of sexually transmitted diseases is necessary for preventing them. Social media, newspapers and journals, television broadcasting, internet sources, and medical campaigning are the ways through which the transmission, symptoms, prevention, and prospective cure of STDs are conveyed to the common people. Examples of sexually transmitted diseases are- AIDS, gonorrhea, syphilis, etc.
STD is an abbreviated form of Sexually transmitted diseases. The meaning of STD disease is that the disease is imparted to others through sexual contact. Apart from sexual transmission, sexually transmitted diseases are also transferred to other persons in various ways. These are- breastfeeding, sharing of infected needles, etc. There are many diseases under the class of STD, and these can be cured by maintaining proper sexual health and hygiene. The mass awareness of sexually transmitted diseases is necessary for preventing them. Social media, newspapers and journals, television broadcasting, internet sources, and medical campaigning are the ways through which the transmission, symptoms, prevention, and prospective cure of STDs are conveyed to the common people. Examples of sexually transmitted diseases are- AIDS, gonorrhea, syphilis, etc.
Group of communicable diseases in which sexual contact is the most important mode of transmission.
Importance:
1. Increasing incidence worldwide.
2. The cost and difficulties in the treatment of the diseases and their complications.
3. It is a socioeconomic problem as well as behavioral one since it is linked to addiction, low level of religious values, increase age of marriage, etc.
syphilis, pathophysiology of syphilis, symptoms of syphilis, mode of transmission of syphilis, complications of syphilis, stages of syphilis, diagnosis of syphilis, pathology of syphilis, syphilis symptoms, syphilis diagnosis, cause of syphilis
Introduction to Sexually transmitted diseases with a concentration on certain diseases like syphilis - herpes - chancroid- gonorrhoea - chamydia - bacteria vaginosis- trichomoniasis-candidiasis- human papilloma virus
Download the Power Point for FREE: http://q.gs/Ea2Gx or https://clk.sh/H7Ef
IEC for STIs
A sexually transmitted infection (STI) is an infection you can get by having sex. Some STIs (such as gonorrhea and chlamydia) infect your sexual and reproductive organs. Others (such as HIV, hepatitis B, and syphilis) cause general body infections. STIs used to be called VDs, or venereal diseases. (http://www.pamf.org/teen/sex/std/)
I Mr. Omkar B. Tipugade, Assistant Professor, Genesis Institute of Pharmacy, Radhanagari. This chapter notes as written as per MSBTE syllabus. Read all notes carefully and all the best for exam and future.
Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, and tertiary)
sexually transmitted infections
pelvic inflammatory disease
1. physiology of vaginal discahrge
Estrogen acts on stratified squamos epithelium of vagina and proliferates it
The normal pH of vagina is 3.5-4.5 with normally present lactobacilli
During menstruation, discharge occurs due to progesterone
Group of communicable diseases in which sexual contact is the most important mode of transmission.
Importance:
1. Increasing incidence worldwide.
2. The cost and difficulties in the treatment of the diseases and their complications.
3. It is a socioeconomic problem as well as behavioral one since it is linked to addiction, low level of religious values, increase age of marriage, etc.
syphilis, pathophysiology of syphilis, symptoms of syphilis, mode of transmission of syphilis, complications of syphilis, stages of syphilis, diagnosis of syphilis, pathology of syphilis, syphilis symptoms, syphilis diagnosis, cause of syphilis
Introduction to Sexually transmitted diseases with a concentration on certain diseases like syphilis - herpes - chancroid- gonorrhoea - chamydia - bacteria vaginosis- trichomoniasis-candidiasis- human papilloma virus
Download the Power Point for FREE: http://q.gs/Ea2Gx or https://clk.sh/H7Ef
IEC for STIs
A sexually transmitted infection (STI) is an infection you can get by having sex. Some STIs (such as gonorrhea and chlamydia) infect your sexual and reproductive organs. Others (such as HIV, hepatitis B, and syphilis) cause general body infections. STIs used to be called VDs, or venereal diseases. (http://www.pamf.org/teen/sex/std/)
I Mr. Omkar B. Tipugade, Assistant Professor, Genesis Institute of Pharmacy, Radhanagari. This chapter notes as written as per MSBTE syllabus. Read all notes carefully and all the best for exam and future.
Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, and tertiary)
sexually transmitted infections
pelvic inflammatory disease
1. physiology of vaginal discahrge
Estrogen acts on stratified squamos epithelium of vagina and proliferates it
The normal pH of vagina is 3.5-4.5 with normally present lactobacilli
During menstruation, discharge occurs due to progesterone
Hearing the word “tumor” may naturally cause fear or panic. But a tumor is simply an abnormal buildup of tissue that occurs when cells divide too quickly or don’t die off as they normally should. A lung tumor is a tumor that occurs in the lung tissue itself or in the airways that lead to the lungs. Your airways include your:
Nose.
The inside of your nose (nasal cavity).
Throat (pharynx).
Voice box (larynx).
Windpipe (trachea).
The large tubes that carry air from your windpipe to your lungs (bronchi).
Lungs.
Lung tumors can either be cancerous (malignant) or noncancerous (benign).
If a healthcare provider tells you that you have a lung tumor and it “looks like it’s benign,” what does that mean? Should you have concerns?
When compared to malignant tumors, benign lung tumors:
Aren’t cancerous, so they won’t spread to other parts of your body.
Grow slowly or might even stop growing or shrink.
Aren’t usually life-threatening.
Usually don’t require removal.
Can expand and push against nearby tissues but won’t invade, destroy or replace other tissues.
Pelvic inflammatory disease is ascending infection from the endocervix. There are two main groups of organisms involved. These are STIs and commensals of the female genital tract
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
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
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 Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
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2. Introduction
• Transmitted by wide range of bacteria, viral,
protozoal and fungal agents and ectoparasites.
• STI’s are infections that are spread from person
to person through intimate sexual contact.
• STI’s are dangerous because they are easily
spread and it is hard to tell just by looking who
has an STI.
3. Epidemiological determinants
• Agent factor: over 20 pathogens are found to be
spread by sexual contact.
▫ Neisseria gonorrhoeae – gonorrhoea
▫ Treponema pallidum- syphilis
▫ Chlamydia trachomatis- urethritis, cervicitis.
▫ Herpes simplex virus- genital herpes
▫ HIV- AIDS
▫ Trichomonas vaginalis – vaginitis.
4. Epidemiological determinants
• Host factor:
▫ Age: highest incidence in 20-24 years followed by
25-29 and 15-19 years
▫ Sex: morbidity is higher in men but is much more
severe in women.
▫ Marital status: higher among singles, divorced and
separated persons.
▫ Socio-economic status: low socio-economic have
high morbidity rates.
5. Epidemiological determinants
• Demographic factors:
▫ Population explosion
▫ Marked increase in young people
▫ Rural to urban migration
▫ Increasing educational opportunities for women
for delaying their marriage and increasing STD
risks.
6. Epidemiological determinants
• Social factors:
▫ Prostitution: major factor in the spread of STD.
Acts as reservoir of infection.
▫ Broken homes: promiscuous women are
withdrawn . Home is unhappy and children reared
in such an atmosphere are likely to go astray in
search of other avenues of happiness.
▫ Sexual disharmony: married people with strained
relation, divorced and separated persons.
▫ Easy money: prostitution is a reflection of poverty.
It provides an occupation for earning easy money
7. Epidemiological determinants
• Social factors:
▫ Emotional immaturity: often stressed as a social
factor in acquiring STDs
▫ Urbanization and industrialization: conductive
type of lifestyles leads to high levels of infections
since long working hours, relative isolation from
the family and social mobility causes causal sexual
relationships.
▫ Social disruption: caused by disasters, wars and
civil unrest
▫ International travel: travellers import and export
the infection
8. Epidemiological determinants
• Social factors:
▫ Changing behaviour patterns: more relaxation to
moral and cultural values in present day society
provides the young people opportunity to break
away from the traditional ways of life
▫ Social stigma: stigma attached to STD accounts for
non- detection of the cases, not disclosing the
source of contact etc.
▫ Alcoholism: effects of alcohol seems to be more
indirect than direct.
9. Common STD’s are:
• Chlamydia
• Gonorrhea
• Genital Herpes (HSV-2)
• Genital Warts (HPV)
• Hepatitis B
• HIV and AIDS
• Pubic Lice
• Syphilis
• Trichomoniasis
10. Clinical spectrum
• Gonococcal infection:
▫ Causes inflammation of genital tract, cervix and
rectum in women
▫ Pharyngitis
▫ Possible complication – PID in women,
epididymis in men
▫ Can cause sub-fertility and urethral strictures
▫ ‘serious consequences in infants- eye infection
leading to blindness if not treated
▫ Antibiotics of choices are: - Ciprofloxacin,
ceftriaxone, cefixime or spectinomycin
11. Clinical spectrum
• Syphilis:
▫ Causes ulceration of the uro-genital tract, mouth
or rectum
▫ Other signs occur in later stages ranges from skin
eruption to cardiovascular and nervous system
complications
▫ Congenital syphilis is important to cause
stillbirths
▫ Antibiotics – penicillin, doxycycline and
erthromycin.
12. Clinical spectrum
• Chlamydial infection:
▫ A high % of people doesn’t have any clinical
manifestations
▫ If they occur they are similar to gonorrhoea.
▫ Complications can result in sterility in women and
vertical transmission during childbirth leading to
conjuctivitis or eye inflammation
▫ In men – epididymis and urethritis
▫ Antibiotics – doxycycline or azithromycin,
alternative can be – amoxycilin, ofloxacin,
erthromycin or tetracycline
13. Clinical spectrum
• Trichomoniasis:
▫ Parasitic infection leading to vaginitis and vaginal
discharge in women
▫ Usually there are no symptoms
▫ In men- urethritis
▫ T. vaginalis can cause adverse outcomes in
pregnancy- low birth weight PROM
▫ Treatment- metronidazole or tinidazole
14. Clinical spectrum
• Chancroid:
▫ After infection, small papule develops at the site of
inoculation, within 2-3 days
▫ Lesion erodes into deep ulcer that is extremely
painful
▫ Painful swelling in inguinal lymph nodes
▫ Antibiotics: - ciprofloxacin, erythromycin,
ceftriaxone and azithromycin
15. Clinical spectrum
• Lymphogranuloma venereum:
▫ Present with swelling of lymph nodes in the groin
▫ 3-30 days after exposure it may pass unrecognised
and resolve spontaeneously
▫ Untreated may cause lymphatic damage resulting
in elephantiasis of genitalia
▫ Antibiotics used are: doxycycline, erythromycin
and tetracycline
16. Clinical spectrum
• Donovanosis:
▫ First manifestation is small papule which ruptures
to form granulomatous lesion that is pain free and
bleeds readily on contact.
▫ Antibiotics used- doxycycline, azithromycin.
Alternatives- erythromycin, tetracycline,
trimethoprim –sulphamethoxale.
17. Clinical spectrum
• Genital herpes:
▫ HSV-2 causes genital herpes
▫ Typical papular lesions that progress to multiple
blisters and ulcers
▫ First episode is frequently associated with
prolonged course of ulceration lasting up to 3-4
weeks.
▫ HSV infection is life long. Subclinical infections
also occur.
▫ There is no cure for HSV-2 infection
▫ Antivirals reduce the severity and duration of
lesions
18. Clinical spectrum
• Human papilloma:
▫ HPV causes genital warts which vary from
common soft, flesh coloured protuberances which
may become cauliflower like to papular flat warts
on drier areas
▫ Seen in any part of genitalia including perianal
region
▫ Manifestation- cervical cancer caused by sub-
types.
▫ Treatment generally reserved for large lesions
19. Syndromic approach to STD
• Common syndromes and sequelae:
▫ Male urethritis
▫ Lower genital syndrome in women
▫ Genital ulceration
▫ Prostitis/colitis
▫ Salphingitis
▫ Epididymis/orchitis
▫ Infertility/ ectopic pregnancy
▫ Postnatal and perinatal morbidity
▫ Hepatitis/hepatic carcinoma
▫ Genital carcinoma
▫ AIDS
20. Syndromic management of urethral discharge
Treatment for gonorrhea and
chlamydial infection.
Health education and
counseling
Examine and treat partners
Follow up, 7- 14 days after
treatment
Discharge persists
Assess: treatment compliance
good and reinfection unlikely
Urethral discharge confirmed
by clinician
Clinical cure
Assess: treatment compliance
bad and/or reinfection likely
Start protocol again
Refer
Laboratory investigations: Gram
stain exam of urethral smear-
shows Gram –ve intracellular
diplococci in case of gnorrhoea
In non- gonococcal urethritis more
than 5 neutrophils/ oil immersion
field are observed
21. Syndromic management of genital ulcer
Vesicular lesion present or
history of vesicular lesions
often recurrent ?
Follow up, after 7 days
Improving?
Refer
Genital ulcer
Herpes management
Clinical cure
22. Control of STDs
• Initial planning
• Intervention strategies
• Support component
• Monitoring and evaluation
23. Initial planning
• Problem definition: define disease problem in
terms of prevalence, psychosocial consequences and
other health effects by geographic areas and
population groups with aid of surveys.
• Establishing priorities: rational planning
requires establishment of priorities. Depends on
magnitude, feasibility of control.
• Setting objectives: priorities must be converted to
discrete, achievable and measurable objectives.
• Considering strategies: variety of strategies
must be planned.
24. Intervention strategies
• Case detection:
• Screening: testing for apparently healthy persons from general
population. High priority is given to special groups i.e. pregnant women,
blood donors industrial workers etc.
• Contact tracing: sexual partners of diagnosed patients are identified,
located, investigated and treated.
• Cluster testing: partners are asked the name of other persons of either
sex who move in same socio-sexual environment. They are screened.
• Case holding and treatment: tendency of drop out is very
common. Therefore every effort should be made to ensure complete
and adequate treatment.
• Epidemiological treatment: also known as contact treatment.
Consists of full therapeutic dose of treatment to persons recently
exposed to STD while awaiting the results of laboratory tests.
Should be combined with venereal examination and tracing of
contacts revealed by the examination
25. Intervention strategies
• Personal prophylaxis: contraceptives,
maintenance of hygiene of the private parts,
vaccines like hepatitis B.
• Health education: principle aim to avoid
STDs, to minimize disease acquisition and
transmission.
26. Support components
• STD clinic: for consultation, investigations and
treatment, contact tracing and other relevant
services. STD clinics should maintain the
anonymity. Center should be housed adjacent to
other medical facilities and training centers
• Laboratory services: for correct diagnosis and
treatment decisions, for contact tracing, surveillance
and detection of resistance
• Primary health care: integrate STD control
activities with primary health care system.
27. Support components
• Information system: data required for STD control activities are:
clinical notification, laboratory notification and sentinel and adhoc
surveillance.
• Legislation: to encourage to seek early treatment and name their
sexual contacts, to screen high risk groups, to improve notification
by general practitioners, health education of public.
• Social welfare measures: STDs are social problems, so there is
need of social therapy.
• Measures include: rehab of prostitutes, provision of recreation
facilities in the community, provision of decent living conditions,
marriage counseling, prohibiting the sale of sexually stimulating
literature, pornographic books or photographs.
28. Monitoring and evaluation
• Ongoing evaluation of disease trends provides
more direct measure of program effectiveness
• It may be used to determine the appropriateness
of the selected intervention.