Sexually Transmitted Disease

Sexually Transmitted Disease are the infections that are transmitted during any type of sexual contact.
It is also called Venereal disease or STD  due to transmission of an infectious oragnaism between sex partner.It is most common infectious disease.
Incidence
  According to WHO  >1 Million people acquire a sexually Transmitted infection STI every day globally.
Approximately 500 million new cases of one of four curable STIs (Chlamydia,gonorrhoea, syphilis and trichomoniasis) occur each year worldwide.
Indian council of medical research (ICMR) Has shown that 6%of adult population in India has one or more STI/RTI. This account to occurrence of about 30 to 35 million episodes every year in the country.
It is an important public health problem in India. India provides a vast playground for the rapid spread of STDs . The main cause for this spread is ignorance. Many STDs show early symptoms, which then disappear without treatment,but the germs continue to remain in the body.
It potentially cause serious and permanent complications in infected people who are not treated in timely and effective way. Millions women ar infected with STDs each year.
A large proportion of new occurrence amongst adolescent and young adults are infected.
STDs affect of all ages.It become more common in recent years, partly because people are becoming sexually active at a younger age ,are having multiple partner, and do not use preventive methods to lessen their chance of acquiring an STD.Infection partner can pass STDs to sexual partners even if they themselves do not have any symptoms.
STDs can occur again and again in same individual because the human body cannot build immunity against them and is no vaccination for them.
In addition STIs are known to facilitate humana immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS).
Mode of spread. ...
The infections can be spread through any type of sexual activity involving..
Sex organs
Anus
Mouth
Contact with blood,body fluids
Tissue removed a STDs infection person and placed in contact with an uninfection person.
Unsterilized needles
Mother to child during pregnancy and childbirth through blood products and tissue transfer.....
Vulnerable groups......
Sexually active teenage girls
Sex workers and their clients
Women who have multiple sexual partners
Etc
General symptoms......
Unusual discharge from vagina
Sores or warnts on the genital area
Painful or frequent urination
Itching and redness in genital area
Blisters or sores in or around the mouth
Abnormal vaginal odour
Anal itching,soreness,or bleeding
Dysparunenia
Abdominal pain
Fever
Diagnosis.,.....
History taking
Clinical examination
Rapid blood test
Management......
Correct diagnosis
Early and effective treatment
Advice on sexual behaviour
Promotion and/or provisions.
Partner notification and treatment
Case reporting and follow up as appropriate.

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Third Complications of labor

चित्र
All women who deliver are at risk of complications in third stage of labor.These complications include Post partum Hemorrahege Retention of placenta (Retained placenta) Inversion of uterus Plumonary embolism Obsteric shock Injurier of birth canal     Retained placenta Management 1) Fundal pressure 2) Controll word traction 3) Manual remove of placenta under Genearl Anesthesia 1) Fundal pressure After seperation of placenta Pressure=Dounword and backward pressure on funda part and pull out the umblical word 2) Controll card traction  placenta separate Pressure on symphysis punia upword and backward Pull out with umblical word 3) Manual remove of placenta under general anesthesia Placent not seperat Female=General Anesthesia (Thiopentel sodiyam 4 to 5 mg/kg) Wear the gloves and insert hand in cone shape manner And reach hoti placenta margin Slicing movemen
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Anatomy and physiology of Vagina to prevent infection

चित्र
In adult female ,vagina is lined by stratified squamous epithelium.In newborn female,it is lined by transitional epithelium.squamous epithelium is resistant to gonococcal infection.Thus , gonococal vaginitis cannot occur in adult female. Vagina has local inhabitant bacteria called Doderlein's bacillus Which breaks down the glycogen present in vaginal epithelium into lactic acid resulting in acidic pH(4-5.5, average 4.5) of vagina.The acidic pH of vagina acts as a barrier for external organism and protect from infection. Physiological vaginal discharge..... Clear, white and flocculent odourless discharge. Smear contains epithelial cells, lactobacillus pH ranges from 3.8 to 4.2 pH increase with increased oestrogen States:in pregnancy,OCP,mid-cycle,PCOS or premenarchal If pH increase in primenopausal woman, investigation for other effects of excess oestrogen. This area is subject to both primary and secondary infection.Ascending infection can occur from the vagina and c
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Antepartum Heamorrhage APH

चित्र
Antepartum haemorrhage APH APH is usually define as bleeding form the birth canal after the 24 to 28 weeks of  pregnancy.It can occur at any time until the second stage of lobour is complete; bleeding following the birth of the baby is postpartum haemorrhage=Miscarriage Or  Any ammount of bleeding from genital tract after 28 weeks to before of bleeding 28wk ..... Delivery time....6wk APH_________IPH_________PPH ETIOLOGY  --- Idiopathic/unknown 2types    1) Placenta previa (pp) 2) Abrupto previa (AP) Placenta previa=in lower uterin segement Implantation posterior wall of bady of uterus near the fundus Abrupto precisa=premature separation of placenta Most common risk of APH Dropping down theory= Drop down in lower uterine segments Implantation Due to less endometrial reactions Increase that cilliary active of fallopian tube A)Types of placenta previa 1)Types 1 (PP)  low lying place
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