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Sexually Transmitted Diseas in India

Dr. Ranjit Chakraborti

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World Health Organization (WHO) estimates that more than 1 million new cases of curable sexually transmitted bacterial infections occur worldwide everyday. STDs are among the most infectious diseases today. With fast lifestyle, night clubs and binge drinking on the rise, sex is no longer a taboo topic. Young men and women talk about it openly and are quite accustomed I having more than one partner. These are high risk women who are at the risk of having STD, which in turn cal further lead to increased risk of infertility, pelvic inflammatory disease, still births and chronic pain. So far more than 20 different types of STDs have been identified. Despite the tremendous progress brought about by investments in maternity care, family planning, child immunization and better nutrition, one crucial element of maternal and child health has been sorely neglected: the prevention and treatment of sexually transmitted diseases. Historically, STDs have also been overlooked in the global fight against infectious diseases, as a result, they continue to drain the lives of young and old throughout the developing world. Depending on the disease, the infection can spread through any type of the sexual activity involving the sex organ or the mouth, the infection can also be spread through contact with blood during sexual activity. Even STD can spread with simple kissing! STDs affect women of all ages. It has become more common now as young people are exposed to fast lifestyle. People can pass on STD to sexual partners even if they do not have any symptoms. Health problems from STD can be more severe in women as compared to men. Some STDs which cause pelvic infections that may lead to scarring of the reproductive system, which can result in an ectopic pregnancy and infertility. STDs may also lead to cervical cancer. STDs can be passed on from the mother to the baby before, during or immediately after birth.

Common Symptoms: " White or abdominal discharge " Irregular spotting " Burning sensation or pain in vagina vulva " Ulcer or swelling or red discolouration of vagina and blisters " Occasionally partners may complain of burning sensation or discharge or ulcer or sore in pelvis " Abdominal pain, acute pain in abdomen with temperature

Common STDs: " Chlamydia Trachomatis is the most commonly sexually transmitted disease. It is caused by bacteria and results in genital infection and is usually treated with antibiotics. It can also lead to chronic pelvic pain and infertility if not treated with antibiotics as it will then spread to other pelvic organs. " Herpes Genitalis is another common STD. It is a viral infection and can cause very painful genital blisters. Anitviral medications are prescribed that helps in reducing the pain and discomfort. " Veneral or Genital Warts, are caused by virus. They may lead to abnormal pap smears. Creams and other medications can cause the warty tissue to disappear but the warts may occur again. " Gonorrhea is another common STD. It is caused by bacteria and can be treated with an antibiotic. Both the woman and her partner need to be treated. Women often do not have any symptoms but a vaginal discharge or painful urination may occur. If untreated, it can cause severe complications. " Trichomonas, may cause a woman to experience foul discharge and extreme itching. It is also treated with antibiotic. " Syphillis is not a common STD. But it can have serious consequences for women with babies. It is a bacterial infection treated by antibiotics. " HIV/AIDS and Hepatitis B are viral infections that can be sexually transmitted from mother to baby during birth or through infected blood. At present there are no cures for these diseases but can be managed with antivirals and other medicines.

Treatment Options Treatment is crucial to prevent the spread of any STD. The treatment of sexual partners prevent recurrence of infection and further spread of the disease. Highly effective single-dose therapies are now available for most common curable STDs. Single-dose regimens are used for treatment of chancroid, non gonociccal urethritis, uncomplicated non gonococcal infections, bacterial vaginosis, trichomoniasis, candidal vaginitis and chlamydial infections. Improved therapies are now available for the treatment of genital herpes and human papillomavirus (HPV) infections. A new testing method for the diagnosis of chlamydial infections employs an extremely accurate urine test that can be easily incorporated into screening programs. Hepatitis A and Hepatitis B vaccines are now recommended for all sexually active adolescents and young adults. It is also important to treat pregnant women so that it is not passed onto the baby after birth. If not treated, infection may spread inside the body leading to septiceamia. Surgical treatment is required if STD is not controlled by medical treatment. Laparoscopy or laparotomy could be done in case of surgical intervention. The selection of an antibiotic to treat any STD will depend on several factors, including: " Actual bacteria causing the infection " Allergies to various antibiotics " Severity of the infection " Resistance to antibiotics All medicines to be taken only after necessary consultation with the doctor. Regardless of the antibiotic prescribed, the woman must remember to take the entire course of antibiotics. Many women take medication till the time they feel better and then stop. But this should not be done as not having the full course will help in re-run of the infection, may be with greater severity.

One should know the things that increase a woman’s chances of getting STD are: " Sexual activity at a young age " Multiple sex partners " Unprotected sex

The key to this problem is Prevention. It is much easier to prevent STDs than to treat them. One must be careful about the sexual activity and use necessary protection. If you have the slightest symptoms, consult the doctor and discuss the problem. Don’t let embarrassment keep you away from seeking medical attention. Pondering to actually see a doctor may allow the disease to spread faster and cause more damage.

Prevention and control are based on 5 major strategies: " Education and counseling of passers at risk to avoid STDs through changes in sexual behaviours. " Identification of asyptomatic persons and symptomatic persons unlikely to go for diagnosis and treatment " Effective diagnosis and treatment of infected persons " Evaluation, treatment and counseling of sex partners infected with STD " Pre exposure vaccination. What one needs to remember are the following: " Safe sex " Avoid multiple partners " Usage of condoms in unplanned sexual activity "

Remember to get treated at the early stage and stay in follow up with the doctor with vaginal swabs, papsmear as may be necessary.



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