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Category Archives: devadminlsh

Penis Captivus – Reality or Hoax?

Posted on February 15, 2016

If you surf the internet or browse the tabloid magazines, you have undoubtedly encountered a variety of stories about bizarre medical conditions. A pregnant man. A woman who gives birth to rabbits. A man with two penises. The majority of these stories are nothing but hoaxes. But occasionally, these bizarre stories can actually be factual.

There are scattered reports about penis captivus, a condition where a man’s penis becomes “stuck” in a woman’s vagina during sexual intercourse. Can such an alarming situation actually happen? Most researchers believe that penis captivus is NOT a myth, although the condition is extremely rare.

Why does penis captivus occur? During sexual intercourse, the penis fills with blood and can become extremely engorged. In addition, the muscles of the vagina contract rhythmically during orgasm. When the man’s engorgement is excessive and the woman’s vaginal contractions are so strong that the vagina actually closes, the penis can become temporarily trapped.

In most cases, the condition is very short-lived – occurring just for a few seconds. After orgasm, the woman’s vaginal muscles relax and the blood flows out of the man’s penis so that he can easily withdraw. However, there are a few cases reported in credible medical journals that are much more severe.

In a 1979 article in British Medical Journal, Dr. F Kraupl Taylor reviewed the literature on penis captivus and concluded that there is “no doubt about the reality of this unusual symptom”. In one paper, a German gynecologist described a couple who found themselves stuck and in intense pain when they attempted to separate. According to the couple, they were bathed in perspiration and their “imprisonment seemed endless”. Another report described a couple who were unable to separate until the woman had been given chloroform.

Another physician, Dr. Brendan Musgrave, published a follow-up report in British Medical Journal in 1980. Dr. Musgrave detailed a personal experience during which a honeymoon couple was brought to Royal Isle of Wight County Hospital in England. The couple was stuck together and could not be separated until the woman was administered an anesthetic.

A more recent incident was reported on the website Medical Daily in 2014. According to the website, an Italian couple was having underwater intercourse at an isolated beach in Porto San Giorgo, Italy when the couple’s genitals became stuck together. In this case, the condition was probably aggravated by the suction increase caused by the water. A doctor was called to the scene but was unable to extricate the man’s penis. The couple was taken to the emergency room of a local hospital, where the woman was given “an injection commonly used to dilate the uterus of pregnant women”. After this, the couple was able to separate with no lasting effects.

Probably the most severe incident of penis captivus was reported in Bulawayo, Zimbabwe. In this case, the couple’s genitals were stuck together for seven hours! Eventually, the man’s father came to their rescue and separated the couple by performing a ritual that involved burning herbs and inhaling the smoke.

Conclusion
Although some cases of penis captivus sound quite terrifying, the good news is that the condition is extremely rare and likely to resolve very quickly. Should you ever find yourself in this situation, the best advice is to simply relax and think about something non-erotic.

References:

1) Penis Captivus: Did it Occur?
Source: British Medical Journal

2) Penis captivus has occurred
Source: British Medical Journal

3) When the Vagina Holds the Penis Captivus: Is the Sexual Affliction as Bad as it Sounds?
Source: Medical Daily

4) Couple Having Underwater Sex Hospitalized After Getting Stuck Together: Is Penis Captivus to Blame?
Source: Medical Daily

Bacterial Vaginosis

Posted on December 1, 2014

Bacterial Vaginosis : Background Bacterial Vaginosis : Treatment
Bacterial Vaginosis : Risk Factors Bacterial Vaginosis : Prevention
Bacterial Vaginosis : Signs and Symptoms Bacterial Vaginosis : Prognosis
Bacterial Vaginosis : Complications Bacterial Vaginosis : References
Bacterial Vaginosis : Diagnosis

Background

Bacterial vaginosis, sometimes referred to as BV, is the most common bacterial infection in women of childbearing age. Bacterial vaginosis occurs when there is an imbalance between “good” and “bad” bacteria in the vagina. Normally, about 95% of bacteria in the vagina are lactobacillus bacteria (“good” bacteria), which keep the vaginal pH level low and control the growth of “bad” bacteria. In women with BV, there are fewer lactobacillus bacteria than normal.

BV can be sexually transmitted, although some women get the infection without being sexually active. For this reason, BV is considered to be a sexually associated infection rather than a sexually transmitted infection. BV is most common among women who have sexual contact with other women. It does not appear to be an infection that is passed from a man to a woman.

Although it is still unclear why some women get the infection, we do know that BV cannot be spread from contact with a toilet seat, hot tub, swimming pool, or contaminated bedding. However, it can sometimes be spread by sharing sex toys.

According to The Centers for Disease Control (CDC), the prevalence in the United States is approximately 21.2 million (29% of women of childbearing age). It occurs in about 25% of pregnant women and about 60% of women who have a sexually-transmitted disease. African-American women and Mexican American women have higher incidence rates than white women (51%, 31%, and 23% respectively).

Risk Factors

Although BV is not always sexually transmitted, the risk of infection is higher among women who have sex with multiple partners, who have a new partner, or who have sex without a condom. Douching can also be a contributing factor, since the antiseptic chemicals in the douche can kill off the good bacteria in the vagina.

Other things that can upset the balance of bacteria in the vagina are recent antibiotic use, pregnancy, poor diet, cigarette smoking, and vaginal products such as sprays, lubricants, and birth control devices.

People who have sexually transmitted infections such as HIV are more likely to also have BV.

Signs and Symptoms

More than half of women with BV do not notice any symptoms at all. When symptoms do occur, they may include an unusual discharge, painful urination, and itching or burning in the vaginal area. Some women experience a strong fishy odor, especially after sexual intercourse.

Complications

In most cases, bacterial vaginosis does not cause other health problems. However, in some cases it can lead to serious complications. During pregnancy, BV can increase the likelihood of premature rupture of the membranes (PROM) and preterm birth (a birth that takes place more than 3 weeks before the baby is due). Infected mothers have a higher risk of having babies with a low birth weight (less than 5.5 pounds). Infected mothers are also more likely to develop uterine infections after childbirth.

BV can facilitate the transmission of other sexually transmitted infections, especially chlamydia, gonorrhea, and HIV. In women who are HIV positive, there is a greater risk of passing the HIV virus to a sexual partner.

Women who have an invasive pelvic procedure such as a cesarean section, an abortion, or a hysterectomy are at greater risk of getting a pelvic infection such as pelvic inflammatory disease or endometritis.

Diagnosis

After you describe your symptoms, your health care provider will do a pelvic examination and inspect your vagina for irritation and abnormal discharge. A sample of vaginal fluid will be examined under a microscope or sent to a lab for testing. In some cases, several drops of potassium hydroxide are added to the sample of vaginal discharge in order to see whether a fishy odor is produced. This is known as the “whiff test”.

To facilitate diagnosis, you should schedule your exam when you are not having your monthly period. Do not douche, use vaginal sprays, or use a tampon within 24 hours of your exam. Use condoms if you have sex within 24 hours of your exam.

Treatment

BV will sometimes clear up on its own without treatment. However, getting treatment is important to avoid complications. Treatment may also reduce the risk for STDs.

BV can be treated with antibiotics, vaginal creams, and suppositories. The most common treatment is an oral medication called metronidazole (Flagyl, Metryl, Protostat). Although some physicians are hesitant to use metronidazole in women who are pregnant, the FDA has classified it as a Category B drug, which means that animal studies have shown no risk to the fetus. According to the CDC, metronidazole can be used even during the first trimester of pregnancy. In patients who drink alcohol, metronidazole can cause very unpleasant side effects including headaches, rapid heartbeat, abdominal cramps, and severe nausea and vomiting. To avoid these side effects, alcoholic beverages should be eliminated during treatment and for at least 3 days after treatment is complete.

A newer oral antibiotic – tinidazole (Tindamax) – has slightly fewer gastrointestinal side effects but has not been studied as extensively. It is classified as a Category C drug, which means that animal studies have shown risk to the fetus, but there have been no controlled studies in women.
Other treatments for BV include vaginal clindamycin cream (Cleocin) and metronidazole gel (Metrogel). For recurrent cases, the CDC is now recommending vaginally-administered boric acid in a gelatin capsule. Probiotics therapy – which attempts to boost the number of good bacteria in the vagina by eating yogurt and other foods containing lactobacilli – is gaining in popularity, especially as a way to prevent recurrences. However, further research is needed to determine the risks and benefits.

BV usually clears up in 2 or 3 days with antibiotics, but it is important to take all of the medicine prescribed to you (usually a 7-day regimen) even if your symptoms disappear. BV will often recur even after successful treatment. In fact, more than half of women have recurrent symptoms within 12 months.

In most cases, male sex partners of women diagnosed with BV do not need to be treated. However, BV may be transferred between female sex partners. Sexual intercourse should be avoided until treatment is complete.

Prevention

Because BV can be transmitted during sexual activity, the most reliable way to prevent infection is to abstain from oral, vaginal, and anal sex or to have a mutually monogamous relationship with an uninfected sex partner. Latex condoms or dental dams can also reduce the risk of spreading the infection.

Douching should be avoided, since it can kill the good bacteria in the vagina. It is also advisable to avoid feminine hygiene sprays, fragranced soaps, and soaps with harsh chemical ingredients. Washing around the vagina and vulva should be minimized – once a day is usually enough.

Prognosis

In general, BV does not cause anything more than embarrassment, discomfort, and inconvenience. However, it is still important to consider prevention techniques such as mutual monogamy.

References:

1) Bacterial Vaginosis – CDC Fact Sheet

Source: Centers for Disease Control

2) Bacterial Vaginosis (BV)

Source: Beforeplay.org

3) Vaginitis

Source: American Sexual Health Association

4) Bacterial Vaginosis

Source: MedicineNet.com

5) Bacterial Vaginosis

Source: Mayo Clinic

6) Bacterial Vaginosis

Source: FamilyDoctor.org

Chancroid

Posted on December 1, 2014

Bacterial Vaginosis : Background Bacterial Vaginosis : Treatment
Bacterial Vaginosis : Risk Factors Bacterial Vaginosis : Prevention
Bacterial Vaginosis : Signs and Symptoms Bacterial Vaginosis : Prognosis
Bacterial Vaginosis : Complications Bacterial Vaginosis : References
Bacterial Vaginosis : Diagnosis

Background

ChancroidChancroid is a sexually transmitted infection characterized by open sores on the genitals. It is caused by a bacteria called Haemophilus ducreyi. It was once common in the United States, but is now very rare. However, the infection still occurs in less-developed and third world countries.

Chancroid is transmitted from person to person through sexual contact. Actual intercourse is not necessary – the infection can be spread by any skin-to-skin genital contact. People can also spread chancroid from one part of the body to another by touching the open sores.

According to The Centers for Disease Control (CDC), only 15 new cases were reported in the United States in 2012. In most cases, these cases involved a person who had travelled outside of the country to an area where the infection is more common. However, since Haemophilus ducreyi is difficult to culture and sometimes goes away without treatment, the condition may be significantly underdiagnosed.

Risk Factors

Chancroid is most common in less-developed and third world countries in Asia, Africa and the Caribbean. It is especially prevalent among men who have frequent contact with prostitutes.

An uncircumcised man has a higher risk of becoming infected, since the foreskin on the penis may conceal sores and promote the spread of bacteria.

People who have other sexually transmitted infections such as HIV are more likely to have chancroid.

Signs and Symptoms

Symptoms of chancroid usually occur 4-10 days after exposure. The initial symptom is a small tender bump in the genitals. Within a day, the bump becomes an open sore (ulcer). The sore is usually soft, painful, and greyish or yellowish grey in color. It bleeds easily if bumped or scraped and may be pus filled. About half of men have only a single sore, while most women have four or more sores. About half of men and women also experience swollen lymph glands in the groin.

In men, the sores typically appear on the head of the penis, shaft of the penis, groove behind the head of the penis, or foreskin. In women, the sores typically appear on the outer lips of the vagina (labia), near the clitoris, or in the perineal area (area between the genitals and anus). Sometimes, the sores spread to the scrotum, rectum, anus, and thighs. Anal sores may bleed and cause painful bowel movements. Pain may also occur during sexual intercourse and urination. Some people feel mildly ill with a moderate fever and lack of energy.

Complications

In most cases, chancroid does not cause other health problems. However, it can sometimes lead to fistulas and scars on the foreskin of the penis in uncircumcised males.

In men and women with swollen lymph nodes, the nodes can break through the skin and cause larges abscesses. It may be necessary to drain the abscesses with a needle or with local surgery. Light scarring may occur.

Chancroid may increase the risk of contracting HIV (the virus that causes AIDS). This is because open sores on the genitals make it easier for the HIV virus to enter the body.
In addition, chancroid in persons with HIV can take much longer to heal.

Diagnosis

After you describe your symptoms, your health care provider will do a pelvic examination, inspecting the sores and checking for enlarged lymph nodes. Usually, a fluid sample is taken from a fresh sore and sent to a laboratory for analysis.

There is no blood test for chancroid, since the bacteria do not enter the bloodstream. However, a blood test is often done to rule out or identify other STDs, including syphilis and genital herpes.

Treatment

Chancroid will sometimes clear up on its own without treatment. However, getting treatment is important to avoid recurrences and to reduce the likelihood of scarring.

Chancroid can be treated effectively with antibiotics including erythromycin, ciprofloxacin, azithromycin, and ceftriaxone. Erythromycin and ciprofloxacin are taken orally for up to 2 weeks. Azithromycin and ceftriaxone may be given in a single dose. Azithromycin is taken orally and ceftriaxone is given as an intramuscular injection. Ceftriaxone is the treatment of choice among pregnant women.

Chancroid usually clears up in 10 to 11 days with antibiotics, but it is important to take all of the medicine prescribed to you even if your symptoms disappear. Sexual relations should be avoided until treatment is complete. All sexual contacts should be notified and treated even if symptoms do not exist.

Prevention

Because chancroid is transmitted during sexual activity, the most reliable way to prevent infection is to abstain from oral, vaginal, and anal sex or to have a mutually monogamous relationship with an uninfected sex partner. Male and female condoms can reduce the risk of spreading the infection, but are not 100% reliable. Washing the genitals after sexual relations can also reduce the risk of infection.

If you think you are infected, avoid any sexual contact until you have been diagnosed and treated. Notify all sexual contacts so that they can be examined and treated. Avoid touching your open sores. If a sore is accidentally touched, wash your hands carefully to avoid spreading the infection to another part of the body.

Prognosis

Although chancroid is rare and does not cause any serious health problems, it is still important to consider prevention techniques such as mutual monogamy.

References:

1) Chancroid
Source: PubMed Health

2) Definition of Chancroid
Source: MedicineNet.com

3) Chancroid
Source: HealthCommunities.com

4) Chancroid
Source: Healthline.com

5) Chancroid
Source: PlannedParenthood.org

6) Genital Ulcers: Chancroid
Source: Physicians’ Desk Reference

7) Chancroid Treatment and Management
Source: Medscape.com

Viagra vs Cialis

Posted on November 20, 2014

Viagra vs Cialis : Background Viagra vs Cialis : Side Effects
Viagra vs Cialis : Mechanism of Action Viagra vs Cialis : Drug Interactions
Viagra vs Cialis : Dosage Viagra vs Cialis : Conclusion
Viagra vs Cialis : Efficacy Viagra vs Cialis : References
Viagra vs Cialis : Duration of Effectiveness

Background

Erectile dysfunction drugs have become a billion dollar industry. Commercials appear on almost every televised sporting event, and men’s magazines are filled with ads to “increase your sexual performance”. Almost everyone is familiar with Viagra, “the little blue pill”. It has been endorsed by celebrities such as NASCAR star Mark Martin, baseball all-star Rafael Palmeiro, and even former Republican presidential candidate Bob Dole. Cialis, another of the dominant erectile dysfunction drugs, has also become a household word. The image of a man and a woman relaxing in separate bathtubs has become as universally recognized as the McDonalds golden arches.

But is there a difference between the erectile dysfunction drugs? Is one safer? More effective? There is no simple answer to these questions. People aren’t all alike, and the treatment that is successful for one man might not be ideal for another. However, it is certainly worthwhile to review the characteristics of each drug. With this knowledge, you and your health care provider should be able to make an informed decision about which drug is right for you.

Mechanism of Action

Viagra (sildenafil) and Cialis (tadalafil) work in a very similar fashion. Both drugs increase the flow of blood into the penis so that when a man is sexually stimulated, he can get and maintain an erection. Viagra and Cialis belong to a class of drugs known as PDE5 inhibitors, which enhance the effect of nitric oxide, a chemical that is normally released during stimulation. Nitric oxide opens and relaxes blood vessels in the penis, thereby increasing inflow and allowing erections to last longer.

It is important to realize that neither drug is an aphrodisiac. You must feel sexually aroused in order for them to cause erections.

Dosage

Viagra is typically prescribed in a dosage of 50 mg, taken as needed approximately 1 hour before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum dose of 100 mg or decreased to 25 mg. In most patients, the maximum recommended dosing frequency is once per day. Viagra is best taken on an empty stomach, since its action may be delayed or impaired when taken with food (especially high-fat foods).

Cialis is typically prescribed in a dosage of 10 mg, taken as needed approximately 45 minutes before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum dose of 20 mg or decreased to 5 mg. In most patients, the maximum recommended dosing frequency is once per day. Cialis can be taken with or without food.

A low-dose version of Cialis for daily use is also available. The recommended starting dose of Cialis for daily use is 2.5 mg, taken at approximately the same time each day.

Efficacy

Viagra and Cialis have both been shown to be effective in 60-70% of men with erectile dysfunction. Because Viagra has been available the longest (since 1998), there is much more research available. There are also more positive testimonials from consumers. But Cialis (which entered the market 5 years later) seems to have a very similar efficacy profile. The least amount of data is available on the low-dose version of Cialis, although one small study showed that efficacy varied greatly depending on the level of erectile dysfunction (73%-82% efficacy in patients with mild erectile dysfunction, 56%-61% efficacy in men with moderate erectile dysfunction, and 27%-33% efficacy in men with severe erectile dysfunction).

There are very few published head-to-head studies comparing Viagra and Cialis. Most studies have compared the drugs to placebo. In addition, it is difficult to make comparisons across studies, since different studies use different measures of efficacy (e.g. improvement in sexual function versus improvement in sexual satisfaction).

Duration of Effectiveness

The main difference between Viagra and Cialis has to do with duration of effectiveness. Viagra lasts about four to five hours, but with Cialis, the window of opportunity ranges from 24 to 36 hours, which is why it is sometimes called “the weekend drug.” For couples who prize sexual spontaneity, Cialis seems to have a clear competitive edge in this category.

With the low-dose version of Cialis for daily use, there is a steady supply of the drug in the bloodstream. Theoretically, this option makes having sex a possibility without any advance planning at all.

Side Effects

Viagra and Cialis have similar side effects. The most common side effect is a headache, which occurs in about 16% of patients. Other common side effects include nasal congestion, facial flushing, stomach ache, and urinary tract infections. Back pain and muscle aches may occur with Cialis, but rarely with Viagra. In some cases, men taking Viagra and Cialis experience temporary vision problems – mainly a blue tinge to the vision or difficulty in distinguishing the colors blue and green. An extremely rare but very serious side effect associated with both Viagra and Cialis is priapism, an abnormally long and painful erection. If not treated promptly, priapism can lead to erectile dysfunction.

When the drugs are used properly, their side effects tend to be relatively mild. Most disappear after a few hours. However, since Cialis has a longer duration of effectiveness, its side effects tend to last longer, which some men find troubling.

Drug Interactions

Viagra and Cialis should not be taken by men who take medicines or recreational drugs containing nitrates. Like Viagra and Cialis, nitrate drugs cause blood vessels to dilate. The combined effects could cause a dramatic drop in blood pressure, resulting in dizziness, fainting, and sometimes loss of consciousness. Nitrate medicines include nitroglycerin and isosorbide (both used to treat the chest pain associated with angina). Nitrates are also contained in street drugs called “poppers” and in some air fresheners which are inhaled to enhance sexual pleasure.

Cialis should not be taken by men who are on medicines called alpha blockers which are sometimes used to treat prostate problems or high blood pressure. Men who take alpha blockers can use Viagra but must allow at least a six hour gap between taking the alpha blocker and Viagra.

Men taking Cialis may experience an unsafe drop in blood pressure if they drink too much alcohol. The same is true for Viagra, but since Viagra is shorter-acting, this may be less of an issue.
Men who have had a heart attack or stroke within the past 6 months and those with certain medical conditions (e.g., poorly controlled high or low blood pressure, poorly controlled diabetes, liver disease, and unstable angina) that make sexual activity inadvisable should not take Viagra or Cialis. Dosages of the drug should be limited in patients with kidney or liver disorders.

Conclusion

Viagra and Cialis have many more similarities than differences. Both drugs appear to be safe and effective. Cialis lasts longer, allowing greater sexual spontaneity, and can be taken with food. However, the side effects of Cialis can be prolonged and there can be an increased risk for drug interactions. In many cases, insurance coverage and cost may be the deciding factors.

If you are suffering from erectile dysfunction, a complete physical examination by your doctor or healthcare provider is essential. In some cases, erectile dysfunction may be a sign of an underlying medical condition. Your doctor can determine if any other conditions are involved and help you choose the best and safest therapy.

References:

1) Viagra
Source: Drugs.com

2) Cialis
Source: Drugs.com

3) The PDE5 inhibitors: Viagra, Levitra, and Cialis
Source: Patient Education Center, Harvard Medical School

4) Erectile dysfunction: Viagra and other oral medications
Source: Mayo Clinic

5) Comparison of Viagra, Levitra, and Cialis
Source: eMed Expert

6) Erectile Dysfunction: Cialis, Levitra, Staxyn, Stendra, and Viagra to Treat ED
Source: WebMD

Pubic Lice

Posted on November 6, 2014

Pubic Lice : Background Pubic Lice : Treatment
Pubic Lice : Risk Factors Pubic Lice : Prevention
Pubic Lice : Signs and Symptoms Pubic Lice : Prognosis
Pubic Lice : Complications Pubic Lice : References
Pubic Lice : Diagnosis

Background

Pubic LicePubic lice, commonly known as “crabs”, are tiny parasites that attach themselves to the skin and hair in the genital area. Occasionally, they can also be found in armpit hair and eyebrows. The scientific name for the parasite is pthirus pubis. Pubic lice are a different type of lice than head lice or body lice. Measuring about 1.6 millimeters in diameter (the size of a pinhead), they received their nickname because their bodies resemble tiny sea crabs.

Pubic lice are most commonly spread during sexual intercourse, although they can also be spread through other types of intimate skin-to-skin contact. Very rarely, they are spread from contact with contaminated bedding, towels, clothing, or upholstered furniture. There is a common myth that public lice can be acquired by sitting on a toilet seat, but this is extremely rare since lice cannot live long away from a warm human body and do not have feet designed to hold onto a smooth surface such as a toilet seat.

The Centers for Disease Control (CDC) does not keep track of pubic lice cases, although from an analysis of medication purchases, it is estimated that there are about three million new cases each year in the United States. However, since many people don’t seek treatment, the actual number of cases may be even higher.

Pubic lice are most common in teenagers. Pubic lice in children may be a sign of sexual exposure or abuse. However, in some cases, children can become infected merely by sharing a bed with their infected parents.

When viewed through a strong magnifying glass, pubic lice resemble miniature crabs. They are tan to grayish-white in color and have six legs. The front two legs are very large and look like pincer claws. Females lay eggs (also called nits), which are oval-shaped and usually whitish in color. After about 6-10 days, the eggs hatch into nymphs, which are smaller, immature lice. Nymphs mature into adults after 2-3 weeks. In order to live, nymphs must feed on blood. If a nymph falls off a person, it dies within 1-2 days.

Risk Factors

Pubic lice is found worldwide and occurs in all races, ethnic groups, and socioeconomic classes. It is most common in people who have sex with multiple partners and who have sex as adolescents.

People who have other sexually transmitted infections are more likely to also have pubic lice.

Signs and Symptoms

Symptoms usually appear about 5 days after exposure, although some people have no symptoms at all. The most common symptom is itching or burning in the area covered by pubic hair. The itching often gets worse at night when the lice are biting and feeding. Other symptoms may include sores in the genital area, mild fever, fatigue, irritability, and the presence of lice or nits in the pubic hair.

Complications

A pubic lice infection can sometimes cause minor complications. If bites are scratched too vigorously, the wounds can become infected. Two possible infections are impetigo (a contagious bacterial infection characterized by blisters or sores) and furunculosis (an infection of the hair follicle characterized by boils, or pus-filled bumps). Some people develop discolored skin, with pale blue spots where the lice have been feeding continually. Children who have pubic lice on their eyelashes may develop a type of pink eye (conjunctivitis).

Diagnosis

Unlike many other sexually transmitted diseases, it is usually not necessary to go to a doctor or health care professional in order to determine if you are infected. Pubic lice and eggs can be large enough to be seen with the naked eye, although usually a magnifying glass is necessary. Adult lice are tan to grayish-white in color and look like tiny crabs. You may see them crawling through the pubic hair, but since they tend to crawl more slowly than head or body lice, movement may not be visible. The eggs (nits) are whitish in color and are found in small clumps near the hair roots.

Treatment

There are a variety of effective over-the counter treatments, including lice-killing lotions containing 1% permethrin and mousses containing pyrethrins and piperonyl butoxide. Some common brand names are A-200, RID, and Nix. Products should be applied according to instructions in the package or on the label. Following treatment, nits may still be attached to hair shafts and can be removed carefully with fingernails or a fine-toothed comb. Treatments may need to be repeated in seven to 10 days if live lice are found.

If over-the-counter products don’t work, stronger prescription medications are available. Some of the most common prescription medications are malathion (Ovide), a lotion, and ivermectin (Stromectol), an oral medication. Lindane, a topical treatment, is sometimes prescribed when other treatments fail, but has strong toxicity and is not recommended for pregnant women, breastfeeding women, or children younger than age 2.

If lice or nits are found in the eyebrows, it may be possible to gently remove them with a fingernail, tweezers, or nit comb. However, in many cases, a prescription ophthalmic ointment containing petrolatum is recommended. Regular petroleum jelly (Vaseline) should not be used since it can irritate the eyes if it comes in contact.

All sexual partners and anyone who may have been exposed to public lice should be treated at the same time in order to avoid re-infection. Sexual intercourse should be avoided until treatment is complete. People with pubic lice should also be evaluated for other sexually transmitted diseases.

Over-the-counter and prescription medications are only the first part of a successful treatment program. Lice that may remain in clothing and the environment must be killed as well. All bedding, towels, and clothing that may have been exposed should be thoroughly washed with hot, soapy water and dried on high heat for at least 20 minutes. Unwashable items should be dry cleaned, sprayed with a medicated spray, or sealed in an airtight bag for at least two weeks. The entire home should be thoroughly vacuumed.

Hot baths, shaving pubic hair, and other home remedies are not effective ways to treat pubic lice.

Prevention

Birth control methods – including condoms – do not protect against pubic lice. The only thing that can reduce the risk is to abstain from oral, vaginal, and anal sex or to have a mutually monogamous relationship with an uninfected sex partner.

Avoid having sexual contact or sharing bedding or clothing with anyone who has an infestation. Do not resume until treatment is complete.

Prognosis

In general, pubic lice do not cause anything more than embarrassment, discomfort, and inconvenience. Although secondary infections sometimes occur due to vigorous scratching, the infestation is unlikely to cause any lasting health concerns. However, it is still important to be aware of treatment options and to consider prevention techniques such as mutual monogamy.

References:

1) Pubic Lice (Crabs)
Source: Planned Parenthood Association

2) Pubic Lice
Source: MedicineNet.com

3) Pubic Lice Infestation
Source: Centers for Disease Control and Prevention

4) Pubic Lice: What They Are, How They Spread
Source: EverydayHealth.com

5) Pubic Lice (Crabs)
Source: Mayo Clinic

Hepatitis B

Posted on October 16, 2014

Hepatitis B : Background Hepatitis B : Treatment
Hepatitis B : Risk Factors Hepatitis B : Prevention
Hepatitis B : Signs and Symptoms Hepatitis B : Outlook
Hepatitis B : Complications Hepatitis B : References
Hepatitis B : Diagnosis

Background

Human LiverHepatitis B is an infectious disease caused by the hepatitis B virus (HBV). The virus attacks and damages the liver, and can occasionally cause severe liver damage and even liver cancer. According to an analysis published by the Centers for Disease Control (CDC) in February 2013, about 19,000 new cases of hepatitis B occur in the U.S. each year.

Hepatitis B is transmitted by direct contact with infected blood and other bodily fluids, including semen, vaginal secretions, saliva, and open sores. It can be spread by unprotected sexual activity with an infected person, sharing infected needles during illicit drug use, accidental needle sticks by health care workers, being pierced or tattooed with infected instruments, and exposure to the blood of an infected person. Hepatitis B can also be transmitted from a pregnant woman to her baby during childbirth.

In most cases, the virus is cleared from the body after an acute infection. But sometimes the virus stays in the body and may start reproducing again at any time. In the United States, approximately 1.5 million people have chronic hepatitis B and are sources for hepatitis B transmission to others.

According to a recent study by scientists at Münster University, the hepatitis B virus has been in existence for more than 82 million years! It originally infected birds back when the dinosaurs still roamed the earth. The earliest record of an epidemic caused by hepatitis B virus was in 1883. After an outbreak of smallpox in Bremen, shipyard workers were vaccinated with human lymph. Several months later, many of the workers became ill with jaundice and were diagnosed with serum hepatitis. The source of the epidemic was discovered to be a batch of contaminated lymph.

It wasn’t until 1965 that there was a breakthrough in the understanding of the virus. Dr. Baruch Blumberg, working at the National Institutes of Health (NIH), discovered an antigen that detected the presence of HPV in blood samples. Dr. Blumberg later won the Nobel Prize for his discovery.

A vaccine against hepatitis B has been available since 1982. The vaccine is 95% effective in preventing infection and its chronic consequences.

Risk Factors

Hepatitis B is largely a disease of young adults aged 20-50 years. Men and women who have multiple sex partners are at higher risk, especially if they don’t use a condom. Other high risk groups are Asian and Pacific Islanders, men who have sex with men, people who inject drugs with shared needles, health care workers who are stuck with contaminated needles, people who receive blood transfusions, and people with a history of other sexually transmitted diseases.

People with HIV or other diseases that weaken the immune system are at greater risk of becoming infected with hepatitis B and may develop more severe health problems as a result of the infection. Chemotherapy and immune-suppressing drugs (for transplants or auto-immune diseases) are also risk factors.

Signs and Symptoms

Symptoms of hepatitis B vary depending on whether the disease is acute or chronic. In the acute phase (when a person is initially infected with hepatitis), symptoms include loss of appetite, unexplained fatigue, nausea and vomiting, jaundice (yellowing of the skin and eyes), dark urine, and unusually light colored stools. However, nearly half of those infected have atypical symptoms or no symptoms at all. Symptoms usually appear one to six months after exposure.

Most infected adults are able to fight off the virus and recover completely. However, a low percentage of adults (approximately 5%) go on to develop chronic infection. Chronic hepatitis B can cause liver damage that can later develop into cirrhosis of the liver and liver cancer. Symptoms of chronic infection include persistent jaundice, fatigue, decreased appetite, and joint pain. In severe cases, there can be fluid retention causing swelling of the belly, blood in the stool, and mental confusion. Children younger than age 5 are at much higher risk for chronic infection (approximately 50%) and infants are at an even higher risk (approximately 90%).

People who are infected with hepatitis B for more than 6 months are considered carriers (even if they do not have symptoms). This means that they can transmit the disease to others by having unprotected sex, exposing blood or open sores to others, or sharing an infected needle or syringe.

Complications

A small percentage of patients with chronic hepatitis B develop cirrhosis, or hardening of the liver. Cirrhosis causes liver tissue to scar and stop working. The only treatment for liver failure is a liver transplant, a surgery with many risks and an extended recovery period.

Chronic infection with hepatitis can also lead to liver cancer. About 80% of all primary liver cancers are caused by hepatitis B. In fact, individuals with chronic hepatitis B are 100 times more likely to develop primary liver cancer than uninfected people. Primary liver cancer is one of the deadliest cancers and has a 5-year survival rate of only 10%.

Fulminant hepatitis is a rare but extremely severe form of acute hepatitis B. Patients with fulminant hepatitis typically develop the symptoms seen in acute hepatitis B, but then suddenly (within days or weeks) develop severe, often life-threatening liver failure. Symptoms of severe liver failure include confusion, extreme irritability, fluid retention, bruising or bleeding (due to lack of clotting factors), and coma. There is no medication for fulminant hepatitis; for some people, a liver transplant is the only cure.

Pregnant women can pass the virus to their babies during the birthing process. Without prompt treatment, approximately 40% of babies born to infected mothers will develop chronic hepatitis B, and approximately a quarter of these babies will eventually die from chronic liver disease. Transmission can be prevented if babies are given hepatitis B immune globulin and the hepatitis B vaccine within 12 hours of birth.

Diagnosis

Hepatitis B infection is diagnosed with blood tests. These tests can detect the presence and amount of hepatitis B virus in the blood, as well as the presence of antibodies to the virus. Blood tests can also help determine whether there has been damage to the liver.

In patients with chronic hepatitis B, other diagnostic tests may be necessary to detect liver damage or liver cancer. These include a CT scan (ultrasound) and a liver biopsy. In a liver biopsy, a tissue sample is removed by inserting a long needle into the liver. The tissue is examined under a microscope to detect abnormalities.

Treatment

Acute hepatitis B usually resolves on its own and does not require medical treatment. If a patient has severe symptoms such as vomiting or diarrhea, IV fluids may be prescribed to restore fluids and electrolytes. There are no medications that can prevent acute hepatitis B from becoming chronic.

Chronic hepatitis B can be treated with a variety of medications. However, the disease is rarely cured. The most effective treatment is antiviral drugs, which work by keeping the virus from multiplying. However, antiviral drugs do not clear the virus from the body, and they do not have any effect after the medication is stopped.

Patients with chronic liver disease that does not respond to other treatment may be considered for a liver transplant. This procedure can be life-saving. However, in most cases, the new liver eventually becomes infected with hepatitis B.

Prevention

Fortunately, hepatitis B is usually preventable since there is an effective vaccine. Use of the vaccine has resulted in a large decrease in the number of new infections reported each year. The Advisory Committee on Immunization Practices (ACIP) recommends that all infants receive their first dose of the hepatitis B vaccine in the hospital before they are taken home. They should complete the vaccine series by age 6–18 months. Older children (up to age 18 years) who did not previously receive the vaccine should also be vaccinated. Since 2002, the vaccine has also been recommended for adults.

Because hepatitis B can be transmitted during sexual activity, another way to prevent infection is to abstain from oral, vaginal, and anal sex or to have a mutually monogamous relationship with an uninfected sex partner. When used correctly, latex condoms can lower the risk of transmission of hepatitis B, but are not 100% effective. Most other birth control methods – including the pill, IUD, diaphragm, and spermicides – don’t protect against hepatitis B.

People should not share grooming products or other items that might have blood on them, including razors, toothbrushes, fingernail clippers, etc. People who inject themselves with drugs should not share needles, syringes, or other equipment. People who get tattoos or body piercings should ensure that their artist sterilizes all needles and equipment, uses disposable gloves, and washes hands properly.

Health care workers should follow standard precautions regarding the handling of needles and sharp instruments.

Outlook

Although a diagnosis of hepatitis B can be very upsetting, the good news is that most people with hepatitis B, even those with chronic hepatitis B, can be expected to live a long and healthy life. There are several treatments available that can manage symptoms and slow down the progression of the virus.

However, there is still a need to increase awareness, to promote access to screening and treatment services, and to ensure that preventive measures are universally implemented. The World Health Organization (WHO) has several initiatives that should help. Each year the WHO sponsors World Hepatitis Day (July 28) to increase awareness and understanding of the disease. On June 5, 2014, the WHO convened a historic global partners’ meeting on viral hepatitis in Geneva, Switzerland. The group issued a “call to action” to increase global awareness, prevention, diagnosis, and treatment of the disease.

References:

1) Incidence, Prevalence, and Cost of Sexually Transmitted Infections in the United States – CDC Fact Sheet
Source: Centers for Disease Control and Prevention

2) Viral Hepatitis Fact Sheet
Source: Womenshealth.gov

3) Hepatitis B
Source: Health Aetna InteliHealth

4) Sexually Transmitted Diseases
Source: The Center for Menstrual Disorders and Reproductive Choice

5) General Information: FAQ
Source: Hepatits B Foundation

6) Chronic HBV Infections
Source: Hepatits B Foundation

7) Hepatitis B Information for Health Care Professionals: Perinatal Transmission
Source: Centers for Disease Control and Prevention

8) Hepatitis B Information for Health Care Professionals: Vaccination of Infants, Children, and Adolescents
Source: Centers for Disease Control and Prevention

9) Discovery of a More Than 82 Million Years Old Hepatitis B Virus (press release)
Source: Münster University

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