What are sexually transmitted diseases?
The sexually transmitted diseases
(STD) are a group of communicable diseases caused by a wide range of bacterial,
viral, protozoan and fungal infections transferred predominantly through sexual
contact. Commonly occurring STDs in Bangladesh are Gonococcal arthritis, Non-gonococcal
arthritis, Syphilis, Chlamydiosis, Cancroids, Genital herpes.
Route of transmission:
1. Sexual intercourse.
2. Kissing or touching of
an infected person.
3. Direct contact with
infected secretions in the birth canal during delivery, e.g. ophthalmia
neonatorum.
4. Fomities such as shared
damp towels.
5. via fresh blood, e.g. hepatitis
and Transfusion syphilis.
6. Via blood products or
contaminated needles e.g. Hepatitis, AIDS.
7. Contaminated fingers, e.g.
public lice.
Causes of increased incidence of STD:
1. Prostitution: The
prostitute acts as a reservoir of infection. The prostituant (male component of
prostitution) is equally important.
2. Broken families:
Children of broken families (due to death of one or both presents or their
separation) are frustrated and go to prostitutes.
3. Divorce or separation
or strained marriage life.
4. Easy money:
Prostitution provides an occupation for earning easy money.
5. Emotional immaturity of
teenagers.
6. Sub-normal
intelligence: low
7. Sexual disharmony.
8. Urbanization and
migration of people from rural to urban areas.
9. Industrialization and
growth of populous industrial areas with workers living away from families.
10. Population mobility:
long absence of sexual partner, e.g. tourists, migrant workers.
11. Greater sexual
encounter: More employment, more co-instructive schooling.
12. Changing behavioral
patterns: More frequent premarital and extra marital intercourse, sex freedom.
13. Homosexuality.
14. Economic factors: Rapid economic development, affluence and greater
prosperity.
15. Demographic factors: Population increase, higher student population,
more young people at risk.
16. Social stigma: Shyness__ patients feel shy to go to VD clinic, not
disclosing the source of control, giving a wrong address to avoid
identification, going to quacks for treatment, dropping out drugs before
treatment is complete.
17. Easy to get contraceptives. Oral
contraceptive’s use widespread.
18. low economic condition.
19. Misconception about VD: VD is considered as a symbol of maturity.
20. Alcoholism, as it may encores prostitution.
21. Availability of photograph, blue film, pornography etc.
22. Absence of healthy recreation facilities.
Risk of STDs:
1. Men aged 18-24 years.
2. Women aged 16-24 years.
3. Frequent travelers.
4. Prostitutes.
5. Armed services personnel.
6. Merchant seamen.
7. Entertainers.
8. Homosexual men with multiple partners.
Prevention & control of STD:
1. Early accurate diagnosis by screening, control tracing and cluster testing.
2. Case holding and effective treatment and close follow-up to ensure
cure.
3. Personal prophylaxis using contraceptives (e.g. condom, diaphragm),
vaccines etc.
4. Partner notification- the identification of potentially infected
partners and their treatment.
5. Screening- Certain groups of at-risk patients should be screened,
and routine blood donor and antenatal serological testing should continue.
6. Health and sex education on STDs.
7. Support services: STD clinic, Primary healthcare, Laboratory services for diagnosis, Marriage counseling.
7. Support services: STD clinic, Primary healthcare, Laboratory services for diagnosis, Marriage counseling.
Fixed female sterilization is about 100 percent effective.
Tubectomy is a Standing system for women to birth
control. In operation to be menstruation, abortion after delivery within 7
days. Have a family live two babies, last baby's age 2 years. Woman age below
45 years and must be regular menstruation. There are many advantages for
surgery to the Fallopian tubes and easy recovery.
Fallopian tube
ligation is one of the most general processes of female sterilization. Tubal
ligation may be performed_ a) Immediately after vaginal delivery, b) In conjunction
with a cesarean section or c) as an elective outpatient procedure.
Complication:
1. Hemorrhage from the tube and vessels in the mesosalpinx.
2. Pneumoperitoneum due to induction of carbon dioxide.
3. Diathermy burns of the bowel and other structures.
4. Surgical complication- Puncture of large blood vessels.
5. Postoperative complication- Marlener procedure.
1. Wound infection.
2. Pyrexia
3. Pain in lower abdomen
4. Urinary infection
5. Headache
Late complication:
1. Incisional hernia
2. Menstrual disorder
3. Menorrhagia/ dysmenorrheal/ intermenstrual bleeding.
Merits of tubectomy:
1. It is (99.4 - 99.8) percent effective.
2. Simple and can be done by all the doctors.
3. Accept by the people.
4. Operation is available and done free of cost in Bangladesh (The woman is also given tk. 2000, Shari and medicine).
5. Operation can be reversed, but not easy. It requires micro-surgical techniques and results in future pregnancy in only one third of the cases.)
Demerits of tubectomy:
1. It is permanent method, usually women becomes permanently infertile.
2. May be causes psychological problems.
3. Reversal operation is usually unsuccessful.
4. May be produced complication.
5. Require hospitalization for 1 week (for mini-lab operation).
6. Pain
7. Bleeding
8. Hematoma
9. Depression
10. Incisional hernia
Minilaparotomy:
- A loop of tube is excise. The cut ends are securing a ligature.
- It is important to legate the cut ends with 'Plain catgut'
To reduce maternal mortality rate following by 'Antenatal Care'.
"Antenatal care" is the care of the
woman during pregnancy to bring the mother and child to labour in the best
possible condition. The goal of antenatal care is to have the mother active at
the end of her pregnancy, in good health and to deliver a healthy baby.
Prevention or early recognition of abnormal signs, followed by prompt and
efficient treatment will avert many complications, associated with child
bearing not only during the ante-partum period, but also during and after
delivery.
Objectives
of Antenatal Care:
1. To promote, protect and maintain the
health (physical, mental and emotional well-beings) of the mother during
pregnancy.
2. To detect 'high risk' cases and give
themes special care.
3. To detect higher risk groups for
complications of pregnancy, and prevention of them.
4. To remove anxiety associated with
delivery.
5. To reduce maternal mortality and morbidity
rates.
6. To reduce neonatal and infant mortality
rates.
7. To manage insecure pregnancies with
special attention.
8. To promote nutrition.
9. to show the mother regarding the weather
of non-public hygiene, child care, environmental sanitation and nutrition.
10. To teach the mother to look after her
newborn baby during the first month of life.
11. Medical termination of gestation to
sensitive the mother birth prevention for required.
12. To attended to the under-fives
accompanying the mother. Each patient should carry her antenatal card during
her visit to the clinic.
Schedule
for Antenatal visits:
1) 1st visit at 12 weeks
2) 2nd visit at 21-25 weeks
3) 3rd visit at 26-32 weeks
4) 4th visit at 33-36 weeks
1) 1st visit at 12 weeks
2) 2nd visit at 21-25 weeks
3) 3rd visit at 26-32 weeks
4) 4th visit at 33-36 weeks
If justified condition of the mother any
abnormality visiting are regular.
Antenatal
care is very important in Maternal and Child health services because e.g.
Promotion, protection, nutrition, and maintain personal hygiene.
Subscribe to:
Posts
(
Atom
)
2 comments :
Post a Comment