AIDS (Acquired Immune Deficiency Syndrome)-Modes of Transmission

AIDS is a disease of the immune system that results in the development of either lifethreatening opportunistic infections or the development of unusual malignant manifestation of both.
Although AIDS is classified as an infectious disease,its transmission would seem to require sexual contact or direct entry of virus-infected blood or blood products into the circulation.There is a little evidence that AIDS is transmitted by any non-sexual form or person-to-person contact.
The first recognize case of AIDS occured in male homosexuals and this individuals constitute the main risk group(about three-quarters of reported cases occur in homosexual or bisexual males).
AIDS has been diagnosed in female sexual partners of affected males and in Africa the condition would seem to be spread predominantly by heterosexual intercorse,or by exposure to blood through insect bites or scarification.
A retrovirus known as human T-cells lympotropic virus type III(HTLV III) was identified as the probable cause of AIDS.This virus has been repeatedly isolated from the blood ,semen or saliva of affected individuals.
Although the HTLV-III virus has been identified as the probable agent causing AIDS and AIDS related illness,some individuals who have been exposed to ,or are infected by,the virus do not show an evidence of such disease.
This suggests either a long incubation period or the operation of the other factors during the incubation period,which together with the HTLV-III virus,precipitate the loss of cell-mediate immunity.
One possible factor is seminal fluid,which is thought to have a physiological role as an immunological agent after normal heterosexual intercourse.Repeated exposure to this immunosuppresive agent after intercourse,in conjunction with a virus-infected ejaculate,would certainly explain the high-risk category of homosexual or bisexual males.

Syphilis-Treatment

The specialist venerologist put the treatment for syphilis.
Local treatment is useless because the infection invade deeply and spread by vascular channels at an early stage.The best medication for early syphilis is penicillin to which the treponemes have not so far developed a resistance.The most efficient way to maintaining adequate blood levels is to inject intramuscularly aqueous procaine penicillin daily for 10 days(only after medical prescription).
Late syphilis is also treated with penicillin but the shemes of dosage and nmber of courses vary with its manifestations.Treatment should be proceded by radiological examination of the heart and aorta and by tests on the cerebrospinal fluid.
Even though apparently cured,in case of women it should be given a further course of treatment in their next pregnancy,to protect the fetus.The baby should be assesed 6 weeks and 3 months after birth.

Syphilis-Stages and Manifestation

Syphilis is caused by an organism named spirocheta pallida,and can be found in all stages:primary,secondary and tertiary.Exist an other classification too,as:early,latent,late and congenital stage.The syphilitic infection presents a risk for doctors and nurses exposed,if there is a break in their skin or mucous membrane.
Ordinarily,however,the entry of the spirochete is determinated by sexual contact whit an infected partner.This is true even when the primary stage is on the breast,in the mouth or on the lips,the last sites being determinated by genito-oal coitus rather than by kissing or by drinking from infected containers-as used to be suggested.
We will talk about syphilitic case as a result of sexual intercourse.

The primary stage is found most commonly on the labia majora,labia minora,clitoris,urethral orifice or cervix,but it may be anywhere on the lower genital tract,even the vaginal wall.The signs appears usually in 10-20 days after exposure but the incubation period can be modified by penicillin therapy for gonorrhea and can be as long as 90 days.
The first manifestation is a small papule which quickly breaks down to form an ulcer,the classical features of which are a sharply defined serpiginous outline and a brownish red colour.
In practice the signs are so slight that can pass unnoticed.Indeed,any sort of discrete relatively painless ulceration on the vulva may be a primary syphilitic sign.

The first form(primary stage) heals spontaneously in 1-8 weeks and soon afterwards the secondary stage of syphilis,which resolts from entry of the spirochaetes into the bloodstream,is manifestated by:general systemic upset with lassitude,anorexia,headache,pustular skin rashes which are typically non-irritant,occasional loss of hair,white mucous patches in the mouth and moist and necrotic warts on the vulva and around the anus.
Sometimes secondary manifestation occur before the primary heals,or they may not occur at all.
The first and second stages can last up to 2 years,and all this time the woman(and the man infected0 is a source of infection.

In untreated syphilis the tertiary stage occupies many years during which the organisms of infection attack bones,joints,eyes,blood vesels,the heart and the central nervous system.Tertiary syphilis is also characterized by the formation of localized granulomas in any part of the body.Granulomas on the genital tract are rare but,when they do occur,are most often found on the vulva.They are not painful unless secondarly infected.this late form are rarely seen nowadays.

Gonorrhea-Symptoms and Treatment

Gonorrhea is an infection caused by the gonococcus and in the adult woman is contracted by sexual contact with an infected male.There is usually an interval of 2-5 days between exposure and the development of symptoms,but this interval varies from 1 ti 10 days.however an asymptomatic carrier state can persist for weeks or even months and throughout this time infection can be transmitted.
The bacteria attack first those tissues of the lower genital tract.
The gonococci are also spread by anal coitus.
The initial complaints of the patient are dysuria,frequency and purulent vaginal dscharge.This discharge causes soreness but not pruritus unless there is an associated Trichomonas infection.In severe cases the whole vulva become reddened and swollen.Cyctitis and proctitis can develop.
Generally the infection remains limited to the lower genital tract.Most wemen even in the acute and subacute stages of the primary infection ,notice nothing more than slight frequency,dysuria and discharge ,so slight that they pay little attention.It is this who are responsable for the spread of the infection and they can only be found and treated by an efficient system of "contact tracing".
No matter whether it has a dramatic or quiet onset,gonorrhea persist as a chronic but contagious disease for many years.The organisms linger in the endocervix,Bartholin's glands,periurethral tubules and rectum but gives rise to no symptoms or just a vaginal discharge.
the most important and sequel to gonorrhea is tubal damage and closue which threaten future reproduction.
In the classical case the diagnosis of gonorrhea is usually suggested by the history of esposure,the acuteness of the onset of a purulent discharge,the associated urethritis and the appearance of zones of congestion around the orifices of Bartholin's ducts.
The diagnosis can only be provide by the demonstartion of gonococci in the genital tract secretions or in the lower rectum.
The woman should not have passed urine before examination and not used the shower.Having wiped its orifice clean,the urethra is milked to obtain discharge from the paraurethral glands.
the best time to performe a test is immediatly after menstruation.
Treatment:
If there is a severe systeic reaction,or if acute salpingitis is present,the patient should be put completely at rest in hospital and given intensive antibiotic therapy in divided doses.
Penicillin(injection) is the remedy of choice in gonorrhea.If for any reason penicillin is contraindicated,the next choice is ampicillin taken orally.This can be given in a repeated dose of 2g for divided doses such as 500mg,four time daily for 2-4 days.Before penicillin or ampicillin it is advisable to adminiter with 1/2-1 hour previously probenicid 1g by mouth.
Gonorrhea is diagnosed by a medical test and treated after medical advise and supervision!
Be attent with the health of your sexual life,practice a good hygiene and use condom against transmited sexual diseases!