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The document discusses sexually transmitted infections (STIs), describing their causes, symptoms, modes of transmission and effective treatment approaches. It focuses on commonly encountered STIs like syphilis, gonorrhea, chlamydia, herpes, and HIV. Management of STIs is outlined according to syndrome-based approaches like urethral discharge, genital ulcers, vaginal discharge, lower abdominal pain, and neonatal conjunctivitis.
To Assess the Effectiveness of Structure Teaching Programme on Knowledge Rega...ijtsrd
A Pre experimental study one group pre test and post test design was selected for the study, which was conducted on 60 GNM first year nursing students of Integral Institute Of Nursing Sciences and Research, Lucknow U.P. through Random sampling technique. Data was collected through using a self structured knowledge questionnaire. Researcher introduced her and explained the purpose of study to the sample. Written informed Consent was taken from each sample. Pretest was administered to the group followed by structured teaching programme which took about 45 minutes. Post test was taken after one week of administration of structured teaching programme. Mr. Aarif Mohammad | Mr. Sabeehuddin "To Assess the Effectiveness of Structure Teaching Programme on Knowledge Regarding Prevention of Urinary Tract Infection Among the G.N.M. 1st Year Student in Integral Institute of Nursing Sciences & Research, Lucknow U.P." Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd63501.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/63501/to-assess-the-effectiveness-of-structure-teaching-programme-on-knowledge-regarding-prevention-of-urinary-tract-infection-among-the-gnm-1st-year-student-in-integral-institute-of-nursing-sciences-and-research-lucknow-up/mr-aarif-mohammad
This document provides an overview of urinary tract infections (UTIs). It begins with an anatomical and physiological review of the urinary tract. It then discusses the pathogenesis of UTIs, noting that they usually involve bacterial invasion of the urothelium by pathogens like E. coli that enter through the urethra. The document outlines risk factors for UTIs and their significant health and economic burdens. It provides treatment guidelines for different types of UTIs and discusses alternatives to broad-spectrum antibiotics to minimize ecological impacts.
This document presents a research proposal on determining knowledge and understanding of preventing sexually transmitted infections (STIs) among youth in colleges in Mtwara, Tanzania. The proposal includes an introduction providing background on STIs globally and in Tanzania. It describes common STIs like gonorrhea and associated risks such as multiple partners and unsafe sex. The proposal outlines the study objectives, methodology including a cross-sectional design, and components like sampling, data collection and analysis. The proposal is intended to explore knowledge and prevention of STIs among youth to address high prevalence in the region.
This document discusses sexually transmitted infections (STIs), including an introduction defining STIs, common clinical presentations of STIs, syndromic management of STIs, prevention of STIs, and complications of STIs. It provides details on syndromic management, including the 7 key components: client selection, treatment, compliance, counseling, condom promotion, contact tracing, and follow up. Effective syndromic management of STIs requires recognition of common symptom combinations, knowledge of causative organisms, socio-behavioral characteristics of patients, and local antibiotic susceptibility patterns.
This document provides an overview of sexually transmitted infections (STIs), including common types like chlamydia, gonorrhea, and HIV. It notes that over 1 million people acquire an STI daily, with many experiencing no symptoms. STIs can have serious health consequences if left untreated, such as infertility, increased HIV risk, and mother-to-child transmission. The document defines and describes various STIs, their symptoms, testing and treatment options. Prevention methods like abstinence, mutual monogamy, and condom use are recommended to reduce STI spread.
Definition
PID is a disease of the upper genital tract.
It is a spectrum of infection and inflammation of the upper genital tract organs typically involving the uterus (endometrium), fallopian tubes, ovaries, pelvic peritoneum and surrounding structures.
Epidemiology
Occurs both in the developed and developing
countries.
85 per cent are spontaneous infection in sexually active females of reproductive age.
The remaining 15 per cent follow procedures, which favors the organisms to ascend up.
Two-thirds are restricted to young women of less than 25 years and the remaining one-third limited among 30 years or older.
Risk factors
Menstruating teenagers.
Multiple sexual partners.
Absence of contraceptive pill use.
Previous history of acute PID.
IUD users.
Area with high prevalence of sexually transmitted diseases.
Protective factors
Contraceptive practice
Barrier methods
Oral steroidal contraceptives
Monogamy / Vasectomy
Others
Pregnancy
Menopause
Vaccines
CLINICAL FEATURES
Bilateral lower abdominal and pelvic pain dull in nature.
Fever, lassitude and headache.
Irregular and excessive vaginal bleeding .
Abnormal vaginal discharge (purulent or copious)
Nausea and vomiting.
Dyspareunia.
Pain and discomfort in the right hypochondrium.
Signs
Temperature >38.3°C.
Abdominal palpation
(1) Tenderness on both the quadrants of lower abdomen.
(2) The liver may be enlarged and tender.
Vaginal examination
(1) Abnormal vaginal discharge (purulent).
(2) Congested external urethral meatus or openings of Bartholin’s ducts through which pus may be seen escaping out on pressure.
(3) Speculum examination shows congested cervix with purulent discharge from the canal.
Clinical diagnostic criteria of PID (CDC-2006)
Minimum Criteria
Lower abdominal tenderness.
Adnexal tenderness.
Cervical motion tenderness.
Additional Criteria
Oral temperature > 38.3°C.
Mucopurulent cervical or vaginal discharge.
Raised C-reactive protein and/or ESR.
Definitive Criteria
Histopathologic evidence of endometritis on biopsy.
Imaging study (TVS/MRI) evidence of tubo-ovarian complex.
Laparoscopic evidence of PID
Investigations
Identification of organisms
Blood: Leucocyte count shows leucocytosis to more than 10,000 per cu mm and an elevated ESR value of more than 15 mm per hour.
Laparoscopy
Complications Of Pid
Immediate
Pelvic peritonitis or even generalized
Septicemia
Late
Dyspareunia
Infertility
Chronic pelvic inflammation
Formation of adhesions or hydrosalpinx or pyosalpinx and tubo-ovarian abscess.
Chronic pelvic pain and ill health.
Ambulatory Management Of Acute PID (CDC-2006)
Patient should have oral therapy for 14 days
Regimen A
Levofloxacin 500 mg (or, ofloxacin 400 mg) PO
Metronidazole 500 PO bid
Regimen B
Ceftriaxone 250 mg IM single dose
Doxycycline 100 mg PO BID with or without
Metronidazole 500 mg PO BID for 14
Pelvic inflammatory disease (PID) is an infection and inflammation of the upper female genital tract affecting the uterus, fallopian tubes, ovaries and surrounding structures. It occurs most often in sexually active young women under 25 years old and risk factors include multiple sexual partners and lack of contraceptive use. Common symptoms include lower abdominal pain and fever. Diagnosis is based on clinical criteria such as abdominal and adnexal tenderness. Treatment involves oral or intravenous antibiotics for 14 days to prevent complications like infertility, chronic pelvic pain and tubo-ovarian abscesses.
The document discusses sexually transmitted infections (STIs), describing their causes, symptoms, modes of transmission and effective treatment approaches. It focuses on commonly encountered STIs like syphilis, gonorrhea, chlamydia, herpes, and HIV. Management of STIs is outlined according to syndrome-based approaches like urethral discharge, genital ulcers, vaginal discharge, lower abdominal pain, and neonatal conjunctivitis.
To Assess the Effectiveness of Structure Teaching Programme on Knowledge Rega...ijtsrd
A Pre experimental study one group pre test and post test design was selected for the study, which was conducted on 60 GNM first year nursing students of Integral Institute Of Nursing Sciences and Research, Lucknow U.P. through Random sampling technique. Data was collected through using a self structured knowledge questionnaire. Researcher introduced her and explained the purpose of study to the sample. Written informed Consent was taken from each sample. Pretest was administered to the group followed by structured teaching programme which took about 45 minutes. Post test was taken after one week of administration of structured teaching programme. Mr. Aarif Mohammad | Mr. Sabeehuddin "To Assess the Effectiveness of Structure Teaching Programme on Knowledge Regarding Prevention of Urinary Tract Infection Among the G.N.M. 1st Year Student in Integral Institute of Nursing Sciences & Research, Lucknow U.P." Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd63501.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/63501/to-assess-the-effectiveness-of-structure-teaching-programme-on-knowledge-regarding-prevention-of-urinary-tract-infection-among-the-gnm-1st-year-student-in-integral-institute-of-nursing-sciences-and-research-lucknow-up/mr-aarif-mohammad
This document provides an overview of urinary tract infections (UTIs). It begins with an anatomical and physiological review of the urinary tract. It then discusses the pathogenesis of UTIs, noting that they usually involve bacterial invasion of the urothelium by pathogens like E. coli that enter through the urethra. The document outlines risk factors for UTIs and their significant health and economic burdens. It provides treatment guidelines for different types of UTIs and discusses alternatives to broad-spectrum antibiotics to minimize ecological impacts.
This document presents a research proposal on determining knowledge and understanding of preventing sexually transmitted infections (STIs) among youth in colleges in Mtwara, Tanzania. The proposal includes an introduction providing background on STIs globally and in Tanzania. It describes common STIs like gonorrhea and associated risks such as multiple partners and unsafe sex. The proposal outlines the study objectives, methodology including a cross-sectional design, and components like sampling, data collection and analysis. The proposal is intended to explore knowledge and prevention of STIs among youth to address high prevalence in the region.
This document discusses sexually transmitted infections (STIs), including an introduction defining STIs, common clinical presentations of STIs, syndromic management of STIs, prevention of STIs, and complications of STIs. It provides details on syndromic management, including the 7 key components: client selection, treatment, compliance, counseling, condom promotion, contact tracing, and follow up. Effective syndromic management of STIs requires recognition of common symptom combinations, knowledge of causative organisms, socio-behavioral characteristics of patients, and local antibiotic susceptibility patterns.
This document provides an overview of sexually transmitted infections (STIs), including common types like chlamydia, gonorrhea, and HIV. It notes that over 1 million people acquire an STI daily, with many experiencing no symptoms. STIs can have serious health consequences if left untreated, such as infertility, increased HIV risk, and mother-to-child transmission. The document defines and describes various STIs, their symptoms, testing and treatment options. Prevention methods like abstinence, mutual monogamy, and condom use are recommended to reduce STI spread.
Definition
PID is a disease of the upper genital tract.
It is a spectrum of infection and inflammation of the upper genital tract organs typically involving the uterus (endometrium), fallopian tubes, ovaries, pelvic peritoneum and surrounding structures.
Epidemiology
Occurs both in the developed and developing
countries.
85 per cent are spontaneous infection in sexually active females of reproductive age.
The remaining 15 per cent follow procedures, which favors the organisms to ascend up.
Two-thirds are restricted to young women of less than 25 years and the remaining one-third limited among 30 years or older.
Risk factors
Menstruating teenagers.
Multiple sexual partners.
Absence of contraceptive pill use.
Previous history of acute PID.
IUD users.
Area with high prevalence of sexually transmitted diseases.
Protective factors
Contraceptive practice
Barrier methods
Oral steroidal contraceptives
Monogamy / Vasectomy
Others
Pregnancy
Menopause
Vaccines
CLINICAL FEATURES
Bilateral lower abdominal and pelvic pain dull in nature.
Fever, lassitude and headache.
Irregular and excessive vaginal bleeding .
Abnormal vaginal discharge (purulent or copious)
Nausea and vomiting.
Dyspareunia.
Pain and discomfort in the right hypochondrium.
Signs
Temperature >38.3°C.
Abdominal palpation
(1) Tenderness on both the quadrants of lower abdomen.
(2) The liver may be enlarged and tender.
Vaginal examination
(1) Abnormal vaginal discharge (purulent).
(2) Congested external urethral meatus or openings of Bartholin’s ducts through which pus may be seen escaping out on pressure.
(3) Speculum examination shows congested cervix with purulent discharge from the canal.
Clinical diagnostic criteria of PID (CDC-2006)
Minimum Criteria
Lower abdominal tenderness.
Adnexal tenderness.
Cervical motion tenderness.
Additional Criteria
Oral temperature > 38.3°C.
Mucopurulent cervical or vaginal discharge.
Raised C-reactive protein and/or ESR.
Definitive Criteria
Histopathologic evidence of endometritis on biopsy.
Imaging study (TVS/MRI) evidence of tubo-ovarian complex.
Laparoscopic evidence of PID
Investigations
Identification of organisms
Blood: Leucocyte count shows leucocytosis to more than 10,000 per cu mm and an elevated ESR value of more than 15 mm per hour.
Laparoscopy
Complications Of Pid
Immediate
Pelvic peritonitis or even generalized
Septicemia
Late
Dyspareunia
Infertility
Chronic pelvic inflammation
Formation of adhesions or hydrosalpinx or pyosalpinx and tubo-ovarian abscess.
Chronic pelvic pain and ill health.
Ambulatory Management Of Acute PID (CDC-2006)
Patient should have oral therapy for 14 days
Regimen A
Levofloxacin 500 mg (or, ofloxacin 400 mg) PO
Metronidazole 500 PO bid
Regimen B
Ceftriaxone 250 mg IM single dose
Doxycycline 100 mg PO BID with or without
Metronidazole 500 mg PO BID for 14
Pelvic inflammatory disease (PID) is an infection and inflammation of the upper female genital tract affecting the uterus, fallopian tubes, ovaries and surrounding structures. It occurs most often in sexually active young women under 25 years old and risk factors include multiple sexual partners and lack of contraceptive use. Common symptoms include lower abdominal pain and fever. Diagnosis is based on clinical criteria such as abdominal and adnexal tenderness. Treatment involves oral or intravenous antibiotics for 14 days to prevent complications like infertility, chronic pelvic pain and tubo-ovarian abscesses.
Sexually transmitted diseases (STDs) can be passed from person to person during sexual contact and from mother to baby during pregnancy or childbirth. Common STDs discussed include chlamydia, gonorrhea, herpes, syphilis, HIV, and how each can affect both sexual partners and newborns. STDs are diagnosed through tests and examinations and treated with antibiotics or antiviral medications to cure the infection and prevent transmission. Untreated STDs can lead to long-term health issues like infertility, stillbirth, or developmental delays in infants.
1) Urinary tract infections (UTIs) affect people of all ages and are commonly cystitis (bladder infection) and pyelonephritis (kidney infection).
2) UTIs are caused mainly by Escherichia coli and are classified based on location as upper UTIs involving the kidneys or lower UTIs involving the bladder.
3) Risk factors include age, gender, pregnancy, structural abnormalities, diabetes, and medical procedures while symptoms can range from asymptomatic to pain and fever depending on location.
This document discusses communicable diseases that commonly affect the elderly population. It summarizes that geriatrics refers to healthcare for elderly people, noting that the elderly population is growing rapidly. Some common communicable diseases that impact the elderly include pneumonia, influenza, herpes zoster, urinary tract infections, and gastrointestinal infections such as H. pylori and C. difficile infections. Prevention strategies include vaccination, hygiene practices, and early treatment of infections to prevent worsening and spread.
Endometriosis: an invisible and neglected disease that affects 180 million women. Celebrities and famous women over the years have been known to be affected by this Queen Victoria to Marilyn Monroe to Katrina Kaif who had surgery for endometriosis.
Endometriosis: an invisible and neglected disease that affects 180 million women. Celebrities and famous women over the years have been known to be affected by this Queen Victoria to Marilyn Monroe to Katrina Kaif who had surgery for endometriosis. The old theories of Endometriosis such as Sampsons Theory Angiogenesis, Lymphogenesis theory are no longer acceptable. The Epigenetic/ Genetic theorey has been postulated. ROle of biomarkers in diagnosis Risk factrs affecting Endometriosis and Risk of Cancer is discussed
1. Sexually transmitted diseases (STDs) are caused by bacteria, viruses, parasites or fungi transmitted through sexual contact. Common STDs include chlamydia, gonorrhea, HIV/AIDS, herpes and syphilis.
2. India has a major problem with STDs, with millions of new infections acquired each year. High-risk groups include sex workers, their clients like truck drivers, and individuals with multiple partners or broken homes.
3. Syndromic management is used to clinically diagnose and treat STDs based on symptoms rather than definitive diagnostic testing. It is effective against mixed infections but can promote antibiotic resistance.
Urinary tract infections are caused by pathogenic microorganisms infecting the urinary tract. UTIs can involve different structures like the kidneys (pyelonephritis) or bladder (cystitis). Risk factors include female anatomy, sexual activity, family history. Symptoms range from burning urination to fever. Diagnosis involves urine culture and microscopy showing bacteria and white blood cells. Treatment consists of antibiotics like cephalosporins based on culture sensitivities. Recurrent UTIs may require long term antibiotic prophylaxis.
1-macedaWhat other assessment data would be helpful for the nu.docxteresehearn
1-maceda
What other assessment data would be helpful for the nurse practitioner to have?
The diagnosis of UTI by clinical criteria alone has an error rate of approximately 33%; therefore, the NP should be vigilant and pay attention to additional assessment data (Allen, Manilal & Gezmu, 2019). For example, patient population is typically premenopausal women of any age with risk factors of diabetes, diaphragm use, especially those with spermicide, history of UTI or UTI during childhood, mother or female relatives with history of UTIs, and sexual intercourse.
What are the organisms most likely to cause an UTI?
Urinary tract infections are primarily caused by gram-negative bacteria, but gram-positive pathogens may also be involved. More than 95% of uncomplicated UTIs are monobacterial. The most common pathogen for uncomplicated UTIs is E.coli (75%–95%), followed by Klebsiella pneumoniae, Staphylococcus saprophyticus, Enterococcus faecalis, group B streptococci, and Proteus mirabilis (Bollestad, Vik, Grude& Lindbæk, 2018).
What is the pharmacological treatment for Shelly? Keep in mind safe dosing.
The first step in treating Shelly is to classify the type of infection, such as acute uncomplicated cystitis or pyelonephritis, acute complicated cystitis or pyelonephritis, CA-UTI, asymptomatic bacteriuria (ASB), or prostatitis (Allen, Manilal & Gezmu, 2019). The Infectious Diseases Society of America (IDSA) recommends that empiric regimens for uncomplicated UTIs be guided by the local susceptibility, particularly to E. coli. They recommend considering trimethoprim/sulfamethoxazole if the local resistance rate is less than 20% and fluoroquinolones if the resistance rate is less than 10% (Bollestad, Vik, Grude& Lindbæk, 2018). The empiric regimen for complicated UTIs should also be guided by local susceptibility trends of uropathogens, and definitive regimens should be tailored according to susceptibility results, when available.
What are the teaching priorities for Shelly and her mother prior to her discharge from the clinic?
The teaching priority for Shelly is hydration. During UTI management, hydration dilutes the uropathogen and removes infected urine by frequent bladder emptying. However, the bacterial count returns to the prehydration level after hydration is discontinued. Potential problems with forcing fluids include urinary retention in a patient with a partially obstructed bladder and decreased urinary antibiotic concentration.
References
Allen, M., Manilal, A., Gezmu, T., (2019). Prevalence and associated factors of urinary tract infections among women.
Journal of Urology, 45
(1), 56–62. https://doi.org/10.5152/tud.2018.32855
Bollestad, M., Vik, I., Grude, N., & Lindbæk, M. (2018). Predictors of Symptom Duration and Bacteriuria in Urinary Tract Infection.
Scandinavian Journal of Primary Health Care, 36.
Assess the Prevalence of Self Reported Vaginal Discharge, Perceived Causes an...ijtsrd
Introduction Womens health is often suffering from gynaecological problems between puberty and post menopause. This will have an impression on their sexual and reproductive health. Many ladies find that persistent discharge is often uncomfortable. Objectives The purpose of this study was to determine the prevalence of self reported vaginal discharge, its perceived causes, and any associated symptoms among reproductive aged women.Methods A community based cross sectional study was conducted among women of the reproductive age group 15 45 years from the village of Kondancherry who met the inclusion criteria and were recruited using an appropriate sampling method Convenient . Formal approval was obtained from the village authorities and received approval from the institutions ethics committee. A self structured questionnaire was wont to collect data during a face to face interview. Descriptive and inferential statistics were used to analyse the data.Result Out of a total of 140 women who were interviewed for the presence of abnormal vaginal discharge, 100 71 were found to possess abnormal discharge. The prevalence of discharge was discovered to be quite high. Most of the ladies had a whitish vaginal discharge 76 , 59 had odourless discharge and 43 of women experience cheesy sticky in consistency of discharge. A majority of respondents 26 attributed the cause to excessive body heat, 22 said it was due to eating hot food, and about 13 of women cited stress. The foremost coexisting associated symptoms with vaginal discharge were itching, lower abdominal pain, and backache.Conclusion The stigma, shame, and embarrassment related to with any genital disorder deter many women and girls from seeking medical help. It must be identified and given great importance. Cecyli. C | Yogalakshmi. S "Assess the Prevalence of Self-Reported Vaginal Discharge, Perceived Causes and Associated Symptoms among Reproductive Aged Women" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-5 , October 2023, URL: https://www.ijtsrd.com/papers/ijtsrd59988.pdf Paper Url: https://www.ijtsrd.com/medicine/other/59988/assess-the-prevalence-of-selfreported-vaginal-discharge-perceived-causes-and-associated-symptoms-among-reproductive-aged-women/cecyli-c
This document provides a consensus on the management of urinary tract infections (UTIs) in solid organ transplant recipients from experts in Spain. It summarizes recommendations on screening and treatment of asymptomatic bacteriuria, prophylaxis and treatment of UTIs, management of recurrent UTIs, and interactions between antimicrobials and immunosuppressants. The recommendations are based on a systematic review of the literature and provide evidence levels for each. The goal is to support optimal care of this patient population by incorporating the latest scientific evidence on UTIs in transplant recipients.
Medicine (non resp) treatment guidelines Govt of India Dr Jitu Lal Meena
This document provides guidelines for the treatment of endocervicitis (mucopurulent cervicitis). It describes the signs and symptoms of endocervicitis as well as its typical causative organisms. It recommends presumptive treatment with cefixime and azithromycin or ceftriaxone and doxycycline. It stresses educating and treating patients and partners, promoting condom use, and follow up after one week to ensure compliance and check test results. For recurrent or persistent cervicitis, it recommends reevaluating for possible reexposure or infection and considering alternative treatment courses.
1. Gonorrhea is caused by the bacterium Neisseria gonorrhoeae and can infect the genitals, rectum, and throat through sexual contact. It is the second most commonly reported infectious disease in the US with over 700,000 new cases per year.
2. Symptoms of gonorrhea vary between men and women. Men typically experience painful urination while infections in women are often asymptomatic, leading to untreated pelvic inflammatory disease and infertility.
3. Diagnosis involves gram staining, culture, or detection of bacterial components. Treatment consists of a single dose of ceftriaxone or cefixime plus azithromycin.
Back pain is one of the most common forms of body pain. Back
pain can be felt in many ways. It can range from mild to severe
pain that can affect the ability to move. Back pain can be felt as
muscle pain, stabbing pain, pain that spreads down the legs, and
as reduced flexibility or range of motion. Back pain can be felt as
tingling or pricking, a dull feeling of pain or sharp pain. Back pain
has a number of causes. Back pain can affect your quality of life.
This document provides information about sexually transmitted infections (STIs). It discusses the definitions and differences between STIs and STDs. It also lists some of the most common bacterial, viral, parasitic and fungal STIs such as chlamydia, gonorrhea, herpes, HIV, and trichomoniasis. The document discusses transmission routes, risk factors, prevalence rates among different age groups, and potential complications of untreated STIs. It also describes some common signs and symptoms of STIs for both males and females.
This document provides an overview of acute pelvic inflammatory disease (PID). It discusses the definition, epidemiology, risk factors, microbiology, pathogenesis, stages, clinical features, diagnostic criteria, investigations, management, complications, prevention of reinfection, and follow up of PID. PID is caused by the ascending spread of microorganisms from the cervix to the upper genital tract organs. It is commonly caused by sexually transmitted organisms like N. gonorrhoeae and C. trachomatis. Clinical features include lower abdominal and pelvic pain, fever, abnormal vaginal discharge. Management involves antibiotic therapy based on CDC guidelines to treat infection and prevent complications like infertility.
This document provides an overview of urinary tract infections (UTIs). It discusses the definition, classification, epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, and treatment of UTIs. UTIs are caused by pathogenic microorganisms in the urinary tract and can involve the upper or lower tract. They are commonly classified based on location and risk factors. Escherichia coli is the most common causative organism. Symptoms vary depending on the location of the infection. Diagnosis involves urine testing and culture. Treatment primarily involves use of antibiotics.
Respond on two different days who selected at least one different .docxwilfredoa1
Respond on two different days who selected at least one different factor than you, in one or more of the following ways:Offer alternative diagnoses and prescription of treatment options for urinary tract infections.Share an insight from having read your colleague’s posting, synthesizing the information to provide new perspectives
Main Post
Urinary tract infections (UTI) are one of the most common infections in the world, and advanced practitioners must be able to diagnose and treat the varying types of UTIs. Understanding the location of the UTI, upper or lower, the pathophysiology, and specific signs and symptoms are crucial for treatment. An advanced practitioner must also be aware of the roles that gender and age play in the development of a UTI. UTIs are common in the outpatient setting but can also happen in the hospital and can also be caused by a Foley catheter, which is considered a hospital-acquired event that the hospital will not receive reimbursement.
Pathophysiology of Lower Urinary Tract Infection
A lower urinary tract infection involves the path of least resistance or the most opportunistic point of entry for an organism, usually bacterial and involves the urethra and the bladder. An infection in the urethra or bladder (cystitis) are considered a lower urinary tract infection. The microbial spectrum of UTIs consists mainly of Escherichia coli, with occasional other species of Enterobacteriaceae such as Proteus mirabilis and Klebsiella pneumoniae and other bacteria such as Staphylococcus saprophyticus (Yamamichi, Shigemura, Kitagawa, and Fujisawa, 2018).
Pathophysiology of Upper Urinary Tract Infection
The upper urinary tract consists of the kidneys and ureters. Infection in the upper urinary tract generally affects the kidneys (pyelonephritis), which can cause fever, chills, nausea, vomiting, and other severe symptoms. It can be caused by an infection that has made its way up the urinary tract and can become a complicated infection from an obstruction, such as benign prostatic hypertrophy, and calculi.
Similarities and Differences
Although the location of the infection is different many of the signs and symptoms can present the same; fever, dysuria, frequency, or urgency may be present in both. Many lower tract UTIs may be asymptomatic, and in upper tract UTIs, the symptoms may be more severe, including nausea and vomiting, flank pain, or costovertebral angle tenderness. Finding the underlying cause and treatment is the same; antibiotics for bacterial infections and analgesics for pain control. Intravenous antibiotics are preferred for upper tract UTIs in an attempt to preserve organ damage, but mat be converted to oral after initial treatment.
Gender and Age as Factors
While common in both males and females, females are more prone to community-acquired UTIs than men, basically because of anatomical differences. Lema (2015) ackno.
Comparative Study of Visual, Clinical and Microbiological Diagnosis of White ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
FOURNIER’S GANGRENE: REVIEW OF 57 CASES IN TERTIARY INSTITUTIONAnil Haripriya
Fournier’s gangrene which is a rapidly progressive, fulminant polymicrobial synergistic infection of the perineum and genitals is now changing its pattern. Both genders can be affected and the mortality is still high (around10%). The clinical presentation in many patients in early stage may not be prominent. Thus rapid and accurate diagnosis is must for prompt treatment. Extensive surgical debridement and broad spectrum intravenous antibiotic remains the mainstay of treatment in order to reduce the morbidity and mortality.
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إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
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How Barcodes Can Be Leveraged Within Odoo 17Celine George
In this presentation, we will explore how barcodes can be leveraged within Odoo 17 to streamline our manufacturing processes. We will cover the configuration steps, how to utilize barcodes in different manufacturing scenarios, and the overall benefits of implementing this technology.
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Sexually transmitted diseases (STDs) can be passed from person to person during sexual contact and from mother to baby during pregnancy or childbirth. Common STDs discussed include chlamydia, gonorrhea, herpes, syphilis, HIV, and how each can affect both sexual partners and newborns. STDs are diagnosed through tests and examinations and treated with antibiotics or antiviral medications to cure the infection and prevent transmission. Untreated STDs can lead to long-term health issues like infertility, stillbirth, or developmental delays in infants.
1) Urinary tract infections (UTIs) affect people of all ages and are commonly cystitis (bladder infection) and pyelonephritis (kidney infection).
2) UTIs are caused mainly by Escherichia coli and are classified based on location as upper UTIs involving the kidneys or lower UTIs involving the bladder.
3) Risk factors include age, gender, pregnancy, structural abnormalities, diabetes, and medical procedures while symptoms can range from asymptomatic to pain and fever depending on location.
This document discusses communicable diseases that commonly affect the elderly population. It summarizes that geriatrics refers to healthcare for elderly people, noting that the elderly population is growing rapidly. Some common communicable diseases that impact the elderly include pneumonia, influenza, herpes zoster, urinary tract infections, and gastrointestinal infections such as H. pylori and C. difficile infections. Prevention strategies include vaccination, hygiene practices, and early treatment of infections to prevent worsening and spread.
Endometriosis: an invisible and neglected disease that affects 180 million women. Celebrities and famous women over the years have been known to be affected by this Queen Victoria to Marilyn Monroe to Katrina Kaif who had surgery for endometriosis.
Endometriosis: an invisible and neglected disease that affects 180 million women. Celebrities and famous women over the years have been known to be affected by this Queen Victoria to Marilyn Monroe to Katrina Kaif who had surgery for endometriosis. The old theories of Endometriosis such as Sampsons Theory Angiogenesis, Lymphogenesis theory are no longer acceptable. The Epigenetic/ Genetic theorey has been postulated. ROle of biomarkers in diagnosis Risk factrs affecting Endometriosis and Risk of Cancer is discussed
1. Sexually transmitted diseases (STDs) are caused by bacteria, viruses, parasites or fungi transmitted through sexual contact. Common STDs include chlamydia, gonorrhea, HIV/AIDS, herpes and syphilis.
2. India has a major problem with STDs, with millions of new infections acquired each year. High-risk groups include sex workers, their clients like truck drivers, and individuals with multiple partners or broken homes.
3. Syndromic management is used to clinically diagnose and treat STDs based on symptoms rather than definitive diagnostic testing. It is effective against mixed infections but can promote antibiotic resistance.
Urinary tract infections are caused by pathogenic microorganisms infecting the urinary tract. UTIs can involve different structures like the kidneys (pyelonephritis) or bladder (cystitis). Risk factors include female anatomy, sexual activity, family history. Symptoms range from burning urination to fever. Diagnosis involves urine culture and microscopy showing bacteria and white blood cells. Treatment consists of antibiotics like cephalosporins based on culture sensitivities. Recurrent UTIs may require long term antibiotic prophylaxis.
1-macedaWhat other assessment data would be helpful for the nu.docxteresehearn
1-maceda
What other assessment data would be helpful for the nurse practitioner to have?
The diagnosis of UTI by clinical criteria alone has an error rate of approximately 33%; therefore, the NP should be vigilant and pay attention to additional assessment data (Allen, Manilal & Gezmu, 2019). For example, patient population is typically premenopausal women of any age with risk factors of diabetes, diaphragm use, especially those with spermicide, history of UTI or UTI during childhood, mother or female relatives with history of UTIs, and sexual intercourse.
What are the organisms most likely to cause an UTI?
Urinary tract infections are primarily caused by gram-negative bacteria, but gram-positive pathogens may also be involved. More than 95% of uncomplicated UTIs are monobacterial. The most common pathogen for uncomplicated UTIs is E.coli (75%–95%), followed by Klebsiella pneumoniae, Staphylococcus saprophyticus, Enterococcus faecalis, group B streptococci, and Proteus mirabilis (Bollestad, Vik, Grude& Lindbæk, 2018).
What is the pharmacological treatment for Shelly? Keep in mind safe dosing.
The first step in treating Shelly is to classify the type of infection, such as acute uncomplicated cystitis or pyelonephritis, acute complicated cystitis or pyelonephritis, CA-UTI, asymptomatic bacteriuria (ASB), or prostatitis (Allen, Manilal & Gezmu, 2019). The Infectious Diseases Society of America (IDSA) recommends that empiric regimens for uncomplicated UTIs be guided by the local susceptibility, particularly to E. coli. They recommend considering trimethoprim/sulfamethoxazole if the local resistance rate is less than 20% and fluoroquinolones if the resistance rate is less than 10% (Bollestad, Vik, Grude& Lindbæk, 2018). The empiric regimen for complicated UTIs should also be guided by local susceptibility trends of uropathogens, and definitive regimens should be tailored according to susceptibility results, when available.
What are the teaching priorities for Shelly and her mother prior to her discharge from the clinic?
The teaching priority for Shelly is hydration. During UTI management, hydration dilutes the uropathogen and removes infected urine by frequent bladder emptying. However, the bacterial count returns to the prehydration level after hydration is discontinued. Potential problems with forcing fluids include urinary retention in a patient with a partially obstructed bladder and decreased urinary antibiotic concentration.
References
Allen, M., Manilal, A., Gezmu, T., (2019). Prevalence and associated factors of urinary tract infections among women.
Journal of Urology, 45
(1), 56–62. https://doi.org/10.5152/tud.2018.32855
Bollestad, M., Vik, I., Grude, N., & Lindbæk, M. (2018). Predictors of Symptom Duration and Bacteriuria in Urinary Tract Infection.
Scandinavian Journal of Primary Health Care, 36.
Assess the Prevalence of Self Reported Vaginal Discharge, Perceived Causes an...ijtsrd
Introduction Womens health is often suffering from gynaecological problems between puberty and post menopause. This will have an impression on their sexual and reproductive health. Many ladies find that persistent discharge is often uncomfortable. Objectives The purpose of this study was to determine the prevalence of self reported vaginal discharge, its perceived causes, and any associated symptoms among reproductive aged women.Methods A community based cross sectional study was conducted among women of the reproductive age group 15 45 years from the village of Kondancherry who met the inclusion criteria and were recruited using an appropriate sampling method Convenient . Formal approval was obtained from the village authorities and received approval from the institutions ethics committee. A self structured questionnaire was wont to collect data during a face to face interview. Descriptive and inferential statistics were used to analyse the data.Result Out of a total of 140 women who were interviewed for the presence of abnormal vaginal discharge, 100 71 were found to possess abnormal discharge. The prevalence of discharge was discovered to be quite high. Most of the ladies had a whitish vaginal discharge 76 , 59 had odourless discharge and 43 of women experience cheesy sticky in consistency of discharge. A majority of respondents 26 attributed the cause to excessive body heat, 22 said it was due to eating hot food, and about 13 of women cited stress. The foremost coexisting associated symptoms with vaginal discharge were itching, lower abdominal pain, and backache.Conclusion The stigma, shame, and embarrassment related to with any genital disorder deter many women and girls from seeking medical help. It must be identified and given great importance. Cecyli. C | Yogalakshmi. S "Assess the Prevalence of Self-Reported Vaginal Discharge, Perceived Causes and Associated Symptoms among Reproductive Aged Women" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-5 , October 2023, URL: https://www.ijtsrd.com/papers/ijtsrd59988.pdf Paper Url: https://www.ijtsrd.com/medicine/other/59988/assess-the-prevalence-of-selfreported-vaginal-discharge-perceived-causes-and-associated-symptoms-among-reproductive-aged-women/cecyli-c
This document provides a consensus on the management of urinary tract infections (UTIs) in solid organ transplant recipients from experts in Spain. It summarizes recommendations on screening and treatment of asymptomatic bacteriuria, prophylaxis and treatment of UTIs, management of recurrent UTIs, and interactions between antimicrobials and immunosuppressants. The recommendations are based on a systematic review of the literature and provide evidence levels for each. The goal is to support optimal care of this patient population by incorporating the latest scientific evidence on UTIs in transplant recipients.
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1. Gonorrhea is caused by the bacterium Neisseria gonorrhoeae and can infect the genitals, rectum, and throat through sexual contact. It is the second most commonly reported infectious disease in the US with over 700,000 new cases per year.
2. Symptoms of gonorrhea vary between men and women. Men typically experience painful urination while infections in women are often asymptomatic, leading to untreated pelvic inflammatory disease and infertility.
3. Diagnosis involves gram staining, culture, or detection of bacterial components. Treatment consists of a single dose of ceftriaxone or cefixime plus azithromycin.
Back pain is one of the most common forms of body pain. Back
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This document provides information about sexually transmitted infections (STIs). It discusses the definitions and differences between STIs and STDs. It also lists some of the most common bacterial, viral, parasitic and fungal STIs such as chlamydia, gonorrhea, herpes, HIV, and trichomoniasis. The document discusses transmission routes, risk factors, prevalence rates among different age groups, and potential complications of untreated STIs. It also describes some common signs and symptoms of STIs for both males and females.
This document provides an overview of acute pelvic inflammatory disease (PID). It discusses the definition, epidemiology, risk factors, microbiology, pathogenesis, stages, clinical features, diagnostic criteria, investigations, management, complications, prevention of reinfection, and follow up of PID. PID is caused by the ascending spread of microorganisms from the cervix to the upper genital tract organs. It is commonly caused by sexually transmitted organisms like N. gonorrhoeae and C. trachomatis. Clinical features include lower abdominal and pelvic pain, fever, abnormal vaginal discharge. Management involves antibiotic therapy based on CDC guidelines to treat infection and prevent complications like infertility.
This document provides an overview of urinary tract infections (UTIs). It discusses the definition, classification, epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, and treatment of UTIs. UTIs are caused by pathogenic microorganisms in the urinary tract and can involve the upper or lower tract. They are commonly classified based on location and risk factors. Escherichia coli is the most common causative organism. Symptoms vary depending on the location of the infection. Diagnosis involves urine testing and culture. Treatment primarily involves use of antibiotics.
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Urinary tract infections (UTI) are one of the most common infections in the world, and advanced practitioners must be able to diagnose and treat the varying types of UTIs. Understanding the location of the UTI, upper or lower, the pathophysiology, and specific signs and symptoms are crucial for treatment. An advanced practitioner must also be aware of the roles that gender and age play in the development of a UTI. UTIs are common in the outpatient setting but can also happen in the hospital and can also be caused by a Foley catheter, which is considered a hospital-acquired event that the hospital will not receive reimbursement.
Pathophysiology of Lower Urinary Tract Infection
A lower urinary tract infection involves the path of least resistance or the most opportunistic point of entry for an organism, usually bacterial and involves the urethra and the bladder. An infection in the urethra or bladder (cystitis) are considered a lower urinary tract infection. The microbial spectrum of UTIs consists mainly of Escherichia coli, with occasional other species of Enterobacteriaceae such as Proteus mirabilis and Klebsiella pneumoniae and other bacteria such as Staphylococcus saprophyticus (Yamamichi, Shigemura, Kitagawa, and Fujisawa, 2018).
Pathophysiology of Upper Urinary Tract Infection
The upper urinary tract consists of the kidneys and ureters. Infection in the upper urinary tract generally affects the kidneys (pyelonephritis), which can cause fever, chills, nausea, vomiting, and other severe symptoms. It can be caused by an infection that has made its way up the urinary tract and can become a complicated infection from an obstruction, such as benign prostatic hypertrophy, and calculi.
Similarities and Differences
Although the location of the infection is different many of the signs and symptoms can present the same; fever, dysuria, frequency, or urgency may be present in both. Many lower tract UTIs may be asymptomatic, and in upper tract UTIs, the symptoms may be more severe, including nausea and vomiting, flank pain, or costovertebral angle tenderness. Finding the underlying cause and treatment is the same; antibiotics for bacterial infections and analgesics for pain control. Intravenous antibiotics are preferred for upper tract UTIs in an attempt to preserve organ damage, but mat be converted to oral after initial treatment.
Gender and Age as Factors
While common in both males and females, females are more prone to community-acquired UTIs than men, basically because of anatomical differences. Lema (2015) ackno.
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2. COLLEGE OF MEDICINE AND HEALTH
SCIENCE
DEPARTMENT OF PUBLIC HEALTH (C1)
SEMINAR TITLE:- SYNDROMIC APPROACHS TO STIs /STDs
By: NUREDIN AMAN
Moderator Dr. MAHDER K.
2
3. OUTLINE
OVERVIEW OF MALE AND FEMALE GENITAL ANATOMY
DEFINE OF STDs
DEFINE EPIDEMOLOGY OF STDs
EXPLAIN SYNDROMIC APPROACH
ADVANTAGE AND DISADVANTAGE SYNDROMIC APPROACH
EXPLAIN MOST COMMON STI SYNDROME
REVIEW OF FLOW CHART
ETIOLOGY OF EACH SYNDROME
CLINICAL MANIFESTATION OF EACH SYNDROME
COMPLICATION OF ETIOLOGY
TREATMENT OF EACH SYNDROME
3
4. Female reproductive
Vulva or Pudendum (external genitalia)
Labia majora
Labia minora
Vestibule of the vagina ( urogenital sinus)
4
5. Conti……
Clitoris
Bulbs of the vestibule
Vagina
Uterus
Uterine tube /fallopian / oviducts
Ovaries (oocyte and hormones)
5
9. Male reproductive organ
INCLUDE :
Supporting structures
Scrotum
Penis
Testes (gonads)
A system of ducts
Epididymis
Ductus (vas) deferens ( part of spermatic cord)
Ejaculatory ducts
9
10. Conti…
Urethra ( part of excretory)
Accessory sex glands
Seminal vesicles
Prostate
Bulbourethral glands (Cowper’s gland)_
10
13. Sexually transmitted disease
The term sexually transmitted diseases (STDs) is used to
describe disorders spread by intimate contact.
Although this usually means sexual intercourse, it also
includes close body contact, kissing, cunnilingus,
anilingus, fellatio, mouth–breast contact, and anal
intercourse.
Many STDs can also be transmitted to the fetus in utero
by transplacental spread or passage through the birth
canal and via lactation during the neonatal period.
13
14. Sexually transmitted disease
A group of over 50 infectious diseases are included
under STIs.
Although their etiologies involve a number of
organisms, the infections present themselves
commonly in the following syndromes (genital ulcer,
urethral discharge, vaginal discharge, lower
abdominal pain, scrotal swelling, inguinal bubo and
neonatal conjunctivitis)
14
15. Epidemiology of STIs
Even though there is little information on the incidence and
prevalence of STIs in Ethiopia, the problem of STIs is generally
believed to be similar to that of other developing countries.
According to 2011EDHS, 1%, of each Ethiopian women and men
reported having had an STI in the past 12 months before the
survey. Three percent of women and 2% of men reported having
had an abnormal genital discharge.
Also 1% of each women and men reported having had a
genital sore or ulcer in the 12 months preceding the survey.
These numbers may be underestimated because
respondents could be embarrassed or ashamed to admit
having STIs. 15
15
16. Conti..
The single point adult HIV prevalence estimate for the year 2014 is
1.14%. Taking syphilis and HIV as proxy indicators, the STI
prevalence is in a declining trend.
In the STI surveillance study which was conducted from
January - June 2013 in 8 health facilities located in Amhara,
Oromia and Addis Ababa by EHNRI in collaboration with
CDC-E, a total of 636 STI cases were reported from eight
sentinel surveillance sites and the commonest syndrome was
vaginal discharge (50%), followed by urethral discharge
(31%), genital ulcerative disease (9%), lower abdominal pain
(7.3%) and two syndrome were present in few patients (3%).
16
17. Conti..
About 16% of the STI patients were co-infected with HIV
(8.1% male and 21%female) and HIV prevalence is higher on
STI patients with lower abdominal pain (41%) and genital
ulcer (24.5%). Young people, in the age group 20-34 yrs, were
the highly affected ones (68.2%), with a larger proportion
being females (61%)
17
18. Conti…
Sexually transmitted infections remain a public health
problem of major importance in both developed and
developing countries, but are specially so in developing
countries where access to diagnostic and treatment facilities
is inadequate, very limited or non existent at all. In many
developing countries throughout the world STIs rank among
the top ten conditions for which adults seek health care.
These diseases are important for three reasons, because of
their magnitude, their potential for causing serious
complications and their linkage with HIV/AIDS.
18
19. Conti..
According to a WHO report, in 1995 an estimated 340
million new cases of the five most common curable STIs
occurred
globally in both men and women of 15 - 49 age range. On
average an estimated 930,000 people are infected every day
with curable STI globally.
19
22. Syndromic approach
Syndromic approach is called “Comprehensive approach” because in
addition to the provision of treatment it includes: education of the
patient, condom supply, counseling, partner notification and
management and HIV testing and counseling
Treatment for each syndrome is directed against the main organisms within
that geographical setting responsible for the syndrome.
The syndromic approach has been shown to be highly effective for the
management of majority of the STI. Prompt and efficient case detection and
treatment, results in immediate health benefits for individual patients.
22
26. Introduction to Flow Charts
For each syndrome a clinical algorithm is developed to be followed
in managing STI patients.
A flow chart (also known as an algorithm) is a decision and action
tree. It is like a map that guides the health worker to go through a
series of decisions and actions. Each decision or action is enclosed in
a box, with one or two routes leading out to another box, containing
another decision or action.
26
27. Conti..
Benefits of using flow-charts
They can be used at any time in all types of health facilities.
They suggest clear decisions
Each flow-chart is made up of a series of three steps.
These are:
The clinical problem: is what the patient complains of, i.e. the patient’s presenting symptoms
The decision that needs to be taken: this is the box, which requires further information, which the
health care provider finds out by taking a history or examining the patient.
The action that needs to be carried out: Each of the exit paths leads to an action or do box. This is
the box that instructs the service provider on what action to take.
27
29. URETHRAL DISCHARGE SYNDROME
Urethral discharge is the presence of abnormal secretions from the
distal part of the urethra and it is the characteristic manifestation of
urethritis.
Urethritis is usually due to sexually transmitted infections although
urinary tract infections may produce similar symptoms.
Urethral discharge is one of the commonest sexually transmitted
infections among men in our country. Usually urethral discharge is
accompanied by burning sensations (dysuria) during micturition.
29
30. CONTI…
Person with urethral discharge can also have
increased frequency
urgency of urination
itching sensation of urethra
The amount and nature of the discharge vary according to the
causative agents and other factors like prior treatments with
antibiotics.
30
31. Conti…
The appearance of the discharge can be
purulent or mucoid
clear, white, or yellowish-green
Sometimes it can be associated with scrotal swelling
and pain which tends to be unilateral.
31
32. The causative agents of urethral discharge syndrome are many; but the
two most common causative agents of the syndrome are
Neisseria gonorrhea
Chlamydia trachomatis ( 81% and 36.8% respectively according the
2014 EPHI gonococcal antimicrobial sensitivity validation study ) .
Some of the other causative micro-organisms are mycoplasma
genitalium,Trichomonas vaginalis, and Ureaplasma urealyticum.
Most of the time urethral discharge is due to mixed infection of
Neisseria gonorrhea and Chlamydia trachomatis
ETIOLOGY OF URETHRAL DISCHARGE SYNDROME 32
33. The urethritis caused by N. gonorrhea has usually an acute onset with
profuse and purulent discharge and
The one caused by C. trachomatis has sub-acute onset with scant
mucopurulent discharge.
The other common signs and symptoms are burning sensation during
micturition, urgency and frequency of urination with itching sensation
of the urethra.
The signs and symptoms of complications of the syndrome are
testicular pain and swelling, polyarthralgia, tenosynovitis, arthritis, skin
lesions and constitutional symptoms
CLINICAL MANIFESTATIONS OF URETHRAL
DISCHARGE SYNDROME
33
37. TREATMENT
Ceftriaxone 250mg IM stat/Spectinomycin 2 gm IM stat Plus
Azithromycin 1gm po stat/Doxycycline 100 mg po bid for 7
days/Tetracycline 500 mg po qid for 7 days/Erythromycin 500 mg po qid
for 7 days in cases of contraindications for Tetracycline (children and
pregnancy)
Note: The preferred regimen is Ceftriaxone 250mg IM stat plus
Azithromycin 1gm po stat
37
38. Metronidazole 2 gm po. stat/Tinidazole 1gm po once for 3
days (Avoid Alcohol!)
• Azithromycin 1 g orally in a single dose (only if not used
during the initial episode to address doxycycline resistant
M.genitalium)
TREATMENT OF PERSISTENT/RECURRENT URETHRITIS
SYNDROME
38
39. GENITAL ULCER SYNDROME
Genital ulcer is an open sore or a break in the continuity of the
skin or mucous membrane of the genitalia as a result of sexually
acquired infections.
Commonly genital ulcer is caused by bacteria and viruses.
Genital ulcer facilitates transmission of HIV more than other
sexually transmitted infections because it disrupts continuity of
skins and mucous membranes significantly
39
41. ETIOLOGY OF GENITAL ULCER SYNDROME
There are different kinds of bacteria and viruses which
cause genital ulcer.
Some of the common etiologies of genital ulcer
syndrome are:
Herpes simplex virus (HSV-1 and HSV-2)
Treponema pallidum
Haemophilius ducreyia
Chlamydia trachomatis
41
42. CLINICAL MANIFESTATION
Genital ulcer is caused by different causative agents and due to
this fact genital ulcer has different kinds of clinical manifestations.
Common clinical manifestations of genital ulcer are:
• Constitutional symptoms such as fever, headache, malaise
and muscular pain
• Recurrent painful vesicles and irritations
• Shallow and non-indurated tender ulcers
42
43. Conti...
• Common sites in male are
glance penis , prepuce and penile shaft
• Common sites in women are
vulva $ perineum,
vagina and cervix and can cause occasionally severe vulvo- vaginitis and
necrotizing cervicitis
• Painless indurated ulcer(Chancre)
• Regional lymph adenopathy
43
44. COMPLICATIONS OF GENITAL ULCER
SYNDROME
• Locally destructive granulomatous lesions occur
(Gummas) on the skin, liver, bones, or other organs
• Tabes dorsalis and dementia, often with paranoid features
• Latent meningovascular parenchymatous
• Optic atrophy
• General paresis
• Aortic aneurysm and aortic valve insufficiency
44
46. TREATMENT OF GENITAL ULCER SYNDROME
1. Treatment for Non- Vesicular Genital Ulcer: Benzathine penicillin 2.4
million units IM stat /Doxycycline(in penicillin allergy) 100mg bid for 14
days plus
Ciprofloxacin 500mg bid orally for 3 days /Erythromycin 500mg tab
qid for 7 days plus Acyclovir 400mg tid orally for 10 days (or 200mg
five times per day of 10 day)
2. Treatment for Vesicular, multiple or recurrent genital ulcer Acyclovir
200 mg five times per day for 10 days Or Acyclovir 400 mg tid for 7
day
3. Treatment for recurrent infection: Acyclovir 400 mg tid for 7days
46
47. VAGINAL DISCHARGE SYNDROME
Physiologically women have vaginal discharge which is white mucoid,
odor less and nonirritant, thin or thick based on menstrual cycle. There
is individual variation in the amount of normal vaginal discharges.
Abnormal vaginal discharge which is STI related is abnormal in color,
odor and amount.
In another word abnormal vaginal discharge is there when a women
notices a change in color, odor and amount accompanied by pruritus.
47
49. ETIOLOGY OF VAGINAL DISCHARGE
SYNDROME
The most common causes of vaginal discharge syndrome are
Bacterial vaginosis (Gardnerella vaginalis) is the leading cause of
vaginal discharge in Ethiopia followed by
candidiasis,
trichomoniasis,
gonococcal and
chlamydia cervicitis in that order.
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50. CLINICAL MANIFESTATIONS
The classical manifestation of vaginal discharge is
discharge from the vagina. The discharge can be
• Thin, homogenous whitish discharge with fishy odor
• Thick, profuse, malodorous, yellow-green, frothy itchy
• Purulent exudate from the cervical Os
• White , thick and curd like discharge coating the walls of
the vagina
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51. Conti…
The other manifestations are:
vulvo-vaginal pruritus
, irritation of vulva,
dyspareunia, dysuria, and frequency of urination.
Physical examination may reveal dry congestion of the vulva with
discharge. There can be signs of cervicitis during speculum
examination which are redness and contact bleeding from the
cervix, spotting and endo cervical discharge.
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52. Conti...
The following are the common risk factors for development of
vaginal discharge syndrome secondary to cervicitis:
Multiple sexual partners in the last 3 month
New sexual partner in the last 3 month
Ever traded sex
Age below 25 years
The presences of one or more risk factor suggest cervicitis.
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53. COMPLICATIONS
Untreated vaginal discharge can cause reproductive, sexual and other health
complications. Some of the complications are:
• Pelvic Inflammatory Disease (PID)
• Adhesions and intestinal obstruction
• Ectopic pregnancy
• Premature Rupture of Membrane (PROM) in case of pregnant wom
• Pre-term labor in case of pregnant women
• Low birth weight
• Infertility
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55. TREATMENT OF VAGINAL DISCHARGE
SYNDROME
Risk Assessment Positive
Ceftriaxone 250mg IM stat/Spectinomycin 2 gm IM stat Plus
Azithromycin 1gm po stat/Doxycycline 100 mg po bid Plus
Metronidazole 500 mg bid for 7 days
If discharge is white or curd-like add Clotrimazole
vaginal pessary 200 mg at bed time for 3 days or 7 days
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56. Conti…
Risk Assessment Negative
Metronidazole 500 mg bid for 7 days If discharge is white
or curd-like add
Clotrimazole vaginal pessary 200 mg at bed time for 3
days
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57. 5. LOWER ABDOMINAL PAIN/PELVIC
INFLAMMATORY DISEASE (PID)
Pelvic inflammatory disease (PID) refers to a clinical
syndrome resulting from ascending infection from the cervix and/or
vagina.
PID comprises a spectrum of inflammatory disorders of the upper female genital
tract, including any combination of endometritis, salpingitis, tubo-ovarian abscess
and pelvic peritonitis.
The inflammation may also spread to the liver, spleen or appendix.
The vast majority of PID with or without pelvic abscess improves with antibiotics
alone and the fever usually subsides in less than 72 hours. However, failure to
improve within 72 hours after antibiotic treatment indicates failure of medical
treatment and the patient should be referred for surgical evaluation and
treatment.
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58. ETIOLOGY
PID is frequently poly-microbial. The commonest pathogens associated with PID,
which are transmitted sexually, are C. trachomatis and N. gonorrhoea. Other
causes which may or may not be transmitted sexually include:
• Mycoplasma genitalium
• Bacteroides species
• E. coli
• H. influenza
• Streptococcus
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59. Clinical manifestation
The commonest manifestations of pelvic inflammatory diseases
include
• Lower abdominal pain
• Abnormal vaginal discharge
• Inter-menstrual or post coital bleeding
• Dysuria
• Backache
• Fever, nausea and vomiti
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60. COMPLICATIONS OF LOWER ABDOMINAL PAIN
SYNDROME
If patients with LAP syndrome are not treated appropriately and adequately the
following life threatening complications may occur.
• Peritonitis and intra-abdominal abscess
• Adhesions and intestinal obstruction
• Ectopic pregnancy
• Infertility
• Chronic pelvic pain
• Recurrent PID
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62. TREATMENT OF LOWER ABDOMINAL PAIN
SYNDROME
The treatment regimen should cover all possible
causative agents. The recommended treatment
regimen for lower abdominal pain syndrome is:
For outpatient
Ceftriaxone 250 mg IM stat /Spectinomycin 2gm
i.m stat Plus Azithromycin 1gm po stat/Doxycycline
100 mg po b.i.d for 14 days Plus Metronidazole 500
mg po b.i.d for 14 day
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63. Conti….
INDICATION FOR INPATIENT TREATMENT
Hospitalization of patients with acute PID should be seriously considered
when:
The diagnosis is uncertain
• Surgical emergencies such as appendicitis and ectopic pregnancy cannot
be exclude
• Pelvic abscess is suspected
• Severe illness precludes management on an outpatient basis
• The patient is pregnant
• Patient has failed to respond to outpatient therapy.
• PID in HIV patients
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64. SCROTAL SWELLING SYNDROME
Scrotal swelling can be caused by trauma, tumor, and torsion of
the testis or inflammation of the epididymis.
Mostly the inflammation of the epididymis is caused by sexually
transmitted diseases. The cause of scrotal swelling can vary
depending on the age of the patient.
Among patients who are younger than 35 years, the swelling is likely
to be caused by sexually transmitted infections.
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66. ETIOLOGY SCROTAL SWELLING SYNDROME
The cause of scrotal swelling syndrome can be infectious or non-
infectious. Infectious scrotal swelling caused by:
• N. gonorrhea
• C. trachomatis
• T. pallidum
• M. tuberculosis
• Mumps virus
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67. CLINICAL MANIFESTATIONS OF SCROTAL
SWELLING
Scrotal swelling can manifest itself with different signs and
symptoms. Some of the signs and symptoms of
scrotal swelling are:
• Pain and swelling of the scrotum
• Tender and hot scrotum on palpation
• Edema and erythema of the scrotum
• Dysuria
• Sometimes frequency and urethral discharge can be thereIt is
important to exclude other causes of scrotal swelling like testicular
torsion, trauma, and incarcerated inguinal hernia as they may require
urgent referral for proper surgical evaluation and management
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68. COMPLICATIONS OF SCROTAL SWELLING
SYNDROME
The common complications of scrotal swelling syndrome are:
• Destruction and scarring of testicular tissues
• Infertility
• Impotence
• Prostatitis
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70. TREATMENT OF SCROTAL SWELLING
SYNDROME
Ceftriaxone 250mg i.m stat/ Spectinomycin 2gms i.m stat.
Plus
Azithromycin 1gm po stat/ Doxycycline 100mg po bid for 7
days/ Tetracycline 500mg qid for 7 days
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71. INGUINAL BUBO SYNDROME (SWOLLEN
GLANDS
INGUINAL BUBO SYNDROME (SWOLLEN GLANDS)
Inguinal bubo is defined as swelling of inguinal lymph nodes as a result of
STIs. It should be remembered that infections on the lower extremities or in
the perineum could produce swelling of the inguinal lymph nodes but
strictly speaking this regional enlargement of lymph nodes should not be
regarded as inguinal bubo.
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73. ETIOLOGY
The common causes of inguinal and femoral bubo are:
• Chlamydia trachomatis (L1, L2 and L3)
• Klebsiella granulomatis (donovanosis)
• Treponema pallidum
• Haemophilius ducreyia
CLINICAL MANIFESTATIONS
• Constitutional symptoms of fever, headache and pain
• Tender unilateral or bilateral lymphadenopathy forms a classical
“groove sign” in the inguinal area
• Fluctuant abscess formation which forma coalesce mass (bubo)
• Some time concomitantly occur with genital ulcer
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74. COMPLICATIONS
Fistula or sinus formation
Multiple draining sinus
Extensive ulceration of genitalia
Extensive scarring
Proctocolitis with tenesmus and bloody purulent discharge.
Retroperitoneal lymphadenopathy
Chronic untreated LGV may result in lymphatic obstruction, elephantiasis
of the genitalia
Rarely hematogenous dissemination to lung, liver, spleen and bone
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76. TREATMENT OF INGUINAL BUBO
The treatment regimen for inguinal bubo syndrome in Ethiopia is:
Ciprofloxacin 500mg bid orally for 3 days
Plus
Doxycycline 100 mg bid orally for 14 days /Erythromycin 500mg po qid
for 14 days.
If patient have genital ulcer , add Acyclovir 400mg tid orally for 10 days(
or 200mg five times per day for 10 days)
Note: surgical incisions are contraindicated; aspirate pus with
hypodermic needle through the health skin
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77. NEONATAL CONJUNCTIVITIS
Neonatal conjunctivitis (ophthalmia neonatorum) is an ocular redness,
swelling and drainage which can be sometimes purulent due to pathogenic
agents or irritant chemicals occurring in infants less than 4 weeks of age.
In cases of neonatal conjunctivitis due to pathogenic agents, the neonates
get the infections from their
infected mothers. Neonatal conjunctivitis can cause loss of sight if it is not
managed properly and promptly.
Neonatal conjunctivitis due to sterile chemical irritants can be resolved by
itself within 48 hours without any intervention.
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79. ETIOLOGY OF NEONATALCONJUNCTIVITIS
can be disease causing micro-organisms or sterile chemicals which are irritant
and applied for preventive purposes.
Some of the common etiologic causes of neonatal conjunctivitis are:
N. gonorrhea
S. pneumoniae
H. influenzae
S. aureus
The commonest irritant chemical that causes neonatal conjunctivitis is silver
nitrate solution, which is applied to the eye of the neonate for prophylactic
purposes
79
80. Conti…
COMMON RISK FACTORS OF NEONATAL
CONJUNCTIVITIS
• Maternal infection with STI
• Exposure of the infant to infectious organisms
• Inadequacy of ocular prophylaxis immediately after birth
• Premature rupture of membrane
• Ocular trauma during delivery
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81. CLINICAL MANIFESTATIONS OF NEONATAL CONJUNCTIVITIS
The common clinical presentations of neonatal conjunctivitis
(ophthalmia neonatorum) are:
• Red and edematous conjunctiva
• Edematous eye lead
• Discharge which may be purulent
• Orbital cellulitis in more serious cases
81
82. COMPLICATIONS OF NEONATAL CONJUNCTIVITIS
Neonatal conjunctivitis can lead to some serious ophthalmic complications
if it is not managed promptly. Some of the complications of neonatal
conjunctivitis (ophthalmia neonatorum) are:
• Pseudo membrane formation
• Corneal edema
• Thickened palpebral conjunctiva
• Corneal opacification
• Corneal perforation
• Endophthalmitis
• Blindness
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84. TREATMENT OF NEONATAL CONJUNCTIVITIS
(OPHTHALMIA NEONATORUM
Ceftriaxone 50mg/kg IM stat maximum dose 125/
Spectinomycin 25 mg/kg IM stat maximum dose 75mg plus
Erythromycin 50mg/kg orally in four divided doses for 14
days
Note: TTC is used as prophylaxis for neonatal conjunctivitis but
note for treatment
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85. REFERENCE
NATIONAL GUIDELINES FOR THE MANAGEMENT OF STDs/STIs USING SYNDROMIC
APPROACH ( FMOH) JULY 2015
EPHTI
WHO GUIDELINES FOR THE MANAGEMENT OF STDs/STIs USING SYNDROMIC
APPROACH JULY 2021
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