Gonorrhea and GENITAL WARTS

GONORRHEA and GENITAL WARTS a sweet and small presentation to learn and refer........

1. GONORRHEA Gonorrhea is the sexually transmitted disease that can affect both men and women . It can cause infection in the genitals , rectum & throat . It is very common infection , especially among young people ages 15-24 years . Gonorrhea is known as the clap.

2. CAUSATIVE ORGANISM ‘Gonorrhea is caused by NEISSERIA gonorrhea, gram negative DIPLOCOCCUS.

3. CAUSES/RISK FACTORS Age that is 15-24 years age group. Anyone who is sexually active can get gonorrhea. A pregnant women can give the infection to her baby during childbirth. Early onset of sexually activity. A new sex partners. Multiple sex partners. Previous gonorrhea diagnosis. Having other sexually transmitted infection. Drugs use , prostitution & previous history of gonorrhea , & sexually transmitted infection.

4. CLINICAL FEATURES About 50% of patient with gonorrhea are asymptomatic & even the symptoms are present , they are non specific. Strong smelling vaginal discharge that may be thin & watery or thick and yellow/ green. Irritation or discharge from the anus. Abnormal vaginal bleeding / abnormal mensus. Pain or burning sensation when passing urine. Possible some low abdominal or pelvic tenderness. Low abdominal pain sometimes with nausea. Pain during sexual intercourse. Labia may be swollen & look inflamed. Bartholin gland may be enlarge or palpable tender with fluctuation , suggestive of formation of abcess.

5. INCUBATION PERIOD The incubation period is 3-7 days.

6. DIAGNOSTIC EVALUATION SWAB TESTS– Culture from infection mucus membranes {cervix , rectum or throat} URINE EXAMINATION– First voiding morning urine sample or at least one hour since the last void sample should be tested. Gram staining & NAAT( Neucleic acid amplification test ) should be done.

7. COMPLICATIONS Acute pelvic infection leads to chronic pelvic inflammatory disease. Infertility. Ectopic pregnancy. Dyspareunia. Chronic pelvic pain. Tubo -ovarian mass. Bartholin gland abcess.

8. TREATMENT 1. PREVENTION Use condom. Get tested: Be sure that you & your partners are tested for sexual transmitted infection. Talk to each other about your test result before you have sex. Be monogamous: Having sex with just one partner can lower risk for sexually transmitted infection. To avoid multiple sex partners.

9. 2. MEDICAL MANAGEMENT. Gonorrhea is treated with antibiotics such as according to recommended drugs in acute gonorrhea {CDC 2006}. CEFTRIAXIONE – 125 mg IM. CIPROFLOXACINE– 500mg. OFLOXACIN--- 400mg. CEFIXIME—400mg. LEVOFLOXACIN—250mg In combination with either azythromycin or doxycycline.

10. 3.NURSING MANAGEMENT Advice the patient to practice abstinence. Advice the patient to limit the number of sexual partners. Patient should use condoms for barrier protection. Advice the pregnant women about important of routine screening. Administer prescribed medication. Advice the patient to maintain good personal hygiene habits.

11. GENITAL WARTS Genital warts small, benign growth caused by a viral infection that is HUMAN PAPILLOMA VIRUS typically HPV6 & HPV11. A female with genital warts is at an increase risk for developing cervical cancer. Genital warts often occur in clusters & can be very tiny or can spread into large masses on genital tissues. Females & males in 9-26 years age. Genital warts are highly contagious sexually transmitted disease. Genital warts can travel from one part of the body to another.

12. SITES Cervix. Vagina. Urethra. Perineum. Perineal skin.

13. CAUSATIVE ORGANISM ‘Genital warts is caused by HPV6 &HPV11.

14. CAUSES /RISK FACTORS Human papilloma virus 6&11. To some extent , excessive use of the tobacco & alcohol may lead to formation of genital warts. Pre-malignant or malignant cervical cancer in women also increase the changes of the occuring of genital warts. A person with sexually transmitted diseases are more prone to get affected by genital warts. Genital warts most commonly occur in a person undergoing stress condition. In some cases, use of birth control pills, increased sexual contact without use of barrier protection , multiple sex partners & genital warts. About two-third of people who have sexual contact with someone already having genital warts genital very easily

15. SIGNS & SYMPTOMS Difficulty in passing urine. Itching or burning sensation around the sex organs. Abnormal vaginal bleeding after sexual intercourse. Small fluid- filled blister may occur , which can be very painful , with the first infection they can even take around 2-4 weeks to heal properly. Vaginal discharge. A flu like illness - backache , headache, swollen glands , fever. The small white /yellow/ gray bumps spots may occur on the sex organs & anus. In some chronic cases, cervical cancer may also occur in genital wart.

16. INCUBATION PERIOD ‘The incubation period is 2 weeks to 8 months’.

17. DIAGNOSTIC EVALUATIOIN Visual inspection. Biopsy. Cervical screening : It is used to detect the potentially pre-cancerous and cancerous process in the cervix. Conventional pap smear. Tin prep test slide.

18. COMPLICATION Rarely it can become malignant. Genital warts can proliferate & become more fiberable during pregnancy.

19. MODE OF TRANSMISSION Direct contact : It can transfer from one person to another through sexual contact. It transfer from one part of the body to another.

20. MANAGEMENT PREVENTION Vaccination – Gardasil vaccine , it is quadrivalent vaccine against HPV6,11,16,18. Don’t sex when you have visible warts, even with condoms.

21. TREATMENT CRYOTHERAPY: It is very suitable remedy for genital warts. In this treatment, doctor freez the warts with liquid nitrogen. ELECTROCAUTERY OR DIATHERMY: It is physically destroys the warts by burning them local or general anesthesia can be used. PODOPHYLLIN: It is chemical compound that must be applied by doctor or nurse to the affected area of the skin.

22. PODOFILOX CREAM OR GEL: This is self applied treatment for external genital warts. It is easy to use & is safe and should be applied for about 4 weeks. FLUOROCIL CREAM: It is used mainly to get rid of pain that occur during intercourse . SURGICAL EXCISION: The doctor may use special tools to cut off warts. Local anesthesia is needed for this treatment. TCA{TRICHLORACETIC ACID}: It is another chemical applied to the surface of the warts by a doctor or nurse. LASER THERAPY: During this treatment , warts are destroyed by introducing the laser light to the affected area. This is used for lager or extensive warts.