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Saturday, January 5, 2013

Fetal Development from 1st to 3rd Trimester


First Trimester

Week 2*
Conception is the moment at which the sperm penetrates the ovum. Once fertilized it is called a zygote, until it reaches the uterus 3-4 days later.
Week 4
The embryo may float freely in the uterus for about 48 hours before implanting. Upon implantation, complex connections between the mother and embryo develop to form the placenta.
Week 6
The embryo is about 1/5 of an inch in length. A primitive heart is beating. Head, mouth, liver, and intestines begin to take shape.
Week 10
The embryo is now about 1 inch in length. Facial features, limbs, hands, feet, fingers, and toes become apparent. The nervous system is responsive and many of the internal organs begin to function.
Second Trimester
Week 14
The fetus is now 3 inches long and weighs almost an ounce. The muscles begin to develop and sex organs form. Eyelids, fingernails, and toenails also form. The child’s spontaneous movements can be observed.
Week 18
The fetus is now about 5 inches long. The child blinks, grasps, and moves her mouth. Hair grows on the head and body.
Week 22
The fetus now weighs approximately 1/2 a pound and spans about 10 inches from head to toe. Sweat glands develop, and the external skin has turned from transparent to opaque.
Third Trimester
Week 26
The fetus can now inhale, exhale and even cry. Eyes have completely formed, and the tongue has developed taste buds. Under intensive medical care the fetus has over a 50% chance of surviving outside the womb.
Week 30
The fetus is usually capable of living outside the womb and would be considered premature at birth.
Week 40
This marks the end of the normal gestational period. The child is now ready to live outside of his mother’s womb.
**credits to http://www.wpclinic.org/parenting/fetal-development/ **

Friday, January 4, 2013

In Vitro Fertilization, Artificial Insemination, and other Issues


In Vitro Fertilization Introduction

Infertility is the inability of a couple to become pregnant (regardless of cause) after 1 year of unprotected sexual intercourse -using no birth control methods.
Infertility affects about 6.1 million people in the United States, about 10% of men and women of reproductive age. New and advanced technologies to help a woman become pregnant include in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and other similar procedures.
IVF was used successfully for the first time in the United States in 1981. More than 250,000 babies have been born since then as a result of using the in vitro fertilization technique. IVF offers infertile couples a chance to have a child who is biologically related to them.
With IVF, a method of assisted reproduction, a man's sperm and the woman's egg are combined in a laboratory dish, where fertilization occurs. The resulting embryo is then transferred to the woman's uterus (womb) to implant and develop naturally. Usually, 2-4 embryos are placed in the woman's uterus at one time. Each attempt is called a cycle.

The term test tube baby is often used to refer to children conceived with this technique. The first so-called test tube baby, Louise Brown, reached age 25 years in 2003. She was born in England.

Less than 5% of infertile couples actually use IVF. IVF is usually the treatment of choice for a woman with blocked, severely damaged, or no fallopian tubes. IVF is also used to overcome infertility caused by endometriosis or problems with the man's sperm (such as low sperm count). Couples who simply can't conceive and have tried other infertility methods that have not worked for them can also try IVF.

Factors to Consider

  • Age: Women younger than 35 years who do not have problems with their partners' sperm may try IVF.
  • Multiple births: Generally, in women who use IVF to establish a live birth, about 63% are single babies, 32% are twins, and 5% are triplets or more.
  • Cost: One cycle of IVF costs an average of $12,400.
  • Reduced surgery: If a woman has IVF, she may not have to undergo surgery on her fallopian tubes. It is estimated that the IVF technique has reduced such surgeries by half.
  • Safety: Studies suggest that in vitro fertilization is safe. A recent study covered nearly 1,000 children conceived through these methods in 5 European countries and found that the children, monitored from birth to age 5 years, were as healthy as children conceived naturally. However, other studies have found a slightly increased risk of genetic disorders in children conceived through assisted reproductive technologies.
Artificial Insemination 

Artificial insemination is a technique that can help treat certain kinds of infertility in both men and women. In this procedure, sperm are inserted directly into a woman's cervix, fallopian tubes, or uterus. This makes the trip shorter for the sperm and bypasses any possible obstructions. Ideally, it makes pregnancy possible where it wasn't before. Intrauterine insemination (IUI), in which the sperm is placed in the uterus, is the most common form of artificial insemination.

Though the pregnancy rates for women undergoing artificial insemination may not be as high as they are for some more advanced techniques, this technique has a key advantage: it's a simple procedure with few side effects. For those reasons, your doctor may recommend it as an initial form of treatment for infertility.


Abortion, Early and Unwanted Pregnancy
  • An abortion is a procedure to end a pregnancy. It uses medicine or surgery to remove the embryo or fetus and placenta from the uterus. The procedure is done by a licensed physician or someone acting under the supervision of a licensed physician.
  •  Early and Unwanted Pregnancy

Each year in the U.S. almost one million teenagers become pregnant--at enormous costs to themselves, their children, and society. While the facts are clear, the issues of teenage pregnancy are complicated by our conflicting attitudes and behaviors. Talk of sex fills the airwaves; younger and younger girls are portrayed as sex objects; and sex is used to sell everything from clothing to news. Yet we are shocked at the rising numbers of teens who are sexually active. If we are truly concerned about the welfare of babies, children and adolescents, we must move beyond the moral panic and denial that so often distort the discussion. Designing effective solutions will require the thoughtful separation of fact, assumption and wishful thinking and an honest acknowledgment that much is still not fully understood about the causes of teenage pregnancy.

CONTRIBUTING FACTORS
1. Cause or Effect? The burdens of early childbearing on disadvantaged teens are undeniable. Trying to untangle the factors which contribute to teenage pregnancy from its effects, however, leads to a "which came first, the chicken or the egg?" dilemma. Educational failure, poverty, unemployment and low self-esteem are understood to be negative outcomes of early childbearing. These circumstances also contribute to the likelihood of teen pregnancy. For example, recent studies suggest that most adolescent mothers have already dropped out of school before they become pregnant. On the other hand, adolescents still enrolled in school when they give birth are as likely to graduate as their peers. It is not clear how well the adolescents with the most problems would have fared in the future even without early parenthood.

2. Trends in nonmarital childbearing. It may surprise some to learn that the teen birth rate was 50% higher in 1957 than it is now. Today's widespread concern over teenage pregnancy may have less to do with actual numbers and more to do with the growing percentage of teen mothers who are unmarried. Teens who have babies outside of marriage fit within a broader nationwide trend--unmarried women of all ages are having babies in increasing numbers. Births to single teens actually account for a smaller percentage of all nonmarital births than twenty years ago.

3. Economic forces. In the 1950s when men with little education could find well-paid jobs, young people married if a pregnancy occurred. The loss of those jobs makes marriage less attractive today--an effect that can be seen on teens of all races. In 1955, for example, only 6% of white teenage childbearing occurred outside of marriage; today it is 42%. Economics may also be responsible for the lower percentage of poor adolescents who terminate their pregnancies, since Medicaid policies in most states do not pay for abortions, but do pay for services related to childbirth.

4. Motivation. The Alan Guttmacher Institute states that "while sexual activity among teenagers of all income levels is now common, having a baby is not. Adolescent childbearing is heavily concentrated among poor and low-income teenagers, most of whom are unmarried." While low-income youths may not intend to have a baby, they may not be sufficiently motivated to avoid pregnancy. Without a prize beckoning from the future--a good job, financial independence and marriage--young people from low income backgrounds may have little incentive to delay childbearing.

5. Mixed Messages. The American popular culture glorifies sex and ignores responsibility. Beginning in early childhood, young people are bombarded with sexual messages. At the same time, puritanical attitudes restrict the availability of resources and frank discussions about sex. Other Western nations with similar levels of adolescent sexual activity have much lower rates of adolescent pregnancy than the U.S. In countries with straightforward attitudes about sex, teens get more consistent messages, clearer information and greater access to contraception and abortion.

6. Risk Factors. Although it is not inevitable, some life circumstances place girls at higher risk of becoming teen mothers. These include poverty, poor school performance, growing up in a single parent household, having a mother who was an adolescent mother, or having a sister who has become pregnant.

7. Sexual Abuse and Coercion. A high percentage of girls who have sex before age 15 have been victims of incest or other sexual abuse. Further, half of the fathers of babies born to women aged 15-17 are 20 years of age or older; in one fifth of the cases, they are at least six years older. In the past this behavior would have carried severe social sanctions. Today, few men are prosecuted for having sexual relations with a minor, even though it is still against the law.

 STRATEGIES FOR SUCCESS:
All teenagers need encouragement to postpone sexual involvement and information on pregnancy prevention if they become sexually active. But these components are not enough by themselves to make a significant impact on the reduction of pregnant and parenting teens. The issues of adolescent pregnancy are too complex for simple solutions. The Children's Defense Fund emphasizes that young people need both "the motivation and the capacity to avoid too-early pregnancy and parenting." Further, young people are not a homogenous group, so solutions must be sensitive to individual and group differences. The most successful programs are ongoing and comprehensive. They combine several strategies which focus on helping kids succeed. Boys and girls who do well in school, participate in nonacademic activities, and plan for their future are less likely to become pregnant or bear a child during their teenage years. A wide range of interventions aimed at youth is also insufficient, however, if we do not address the larger overriding issues of poverty, racism and media messages that contribute to the complexity of the problem.




Cloning; Rapid Population; Infertility Drugs

Cloning
            describes the processes used to create an exact genetic replica of another cell, tissue or organism. The copied material, which has the same genetic makeup as the original, is referred to as a clone. The most famous clone was a Scottish sheep named Dolly.
There are three different types of cloning:


  • Gene cloning, which creates copies of genes or segments of DNA
  • Reproductive cloning, which creates copies of whole animals
  • Therapeutic cloning, which creates embryonic stem cells. Researchers hope to use these cells to grow healthy tissue to replace injured or diseased tissues in the human body.Stem cells are cells with the potential to develop into many different types of cells in the body. They serve as a repair system for the body. There are two main types of stem cells: embryonic stem cells and adult stem cells. 
The image below shows the Reproductive Cloning:


Causes of Overpopulation

1. Decline in the Death Rate: The fall in death rates that is decline in mortality rate is one fundamental causes of overpopulation. Owing to the advancements in medicine, man has found cures to the previously fatal diseases. The new inventions in medicine have brought in treatments for most of the dreadful diseases. This has resulted in an increase in the life expectancy of individuals. Mortality rate has declined leading to an increase in population. Owing to modern medications and improved treatments to various illnesses, the overall death rate has gone down. The brighter side of it is that we have been able to fight many diseases and prevent deaths. On the other hand, the medical boon has brought with it, the curse of overpopulation.

2. Rise in the Birth Rate: Thanks to the new discoveries in nutritional science, we have been able to bring in increase in the fertility rates of human beings. Medicines of today can boost the reproductive rate in human beings. There are medicines and treatments, which can help in conception. Thus, science has led to an increase in birth rate. This is certainly a reason to be proud and happy but advances in medicine have also become a cause of overpopulation.

Viewing the issue of increasing population optimistically, one may say that overpopulation means the increase in human resources. The increase in the number of people is the increase in the number of productive hands and creative minds. But we cannot ignore the fact that the increase in the number producers implies an increase in the number of consumers. Greater number of people requires a greater number of resources.
Not every nation is capable of providing its people with the adequate amount of resources. The ever-increasing population will eventually leave no nation capable of providing its people with the resources they need to thrive. When the environment fails to accommodate the living beings that inhabit it, overpopulation becomes a disaster.

3. Migration: Immigration is a problem in some parts of the world. If the inhabitants of various countries migrate to a particular part of the world and settle over there, the area is bound to suffer from the ill effects of overpopulation. If the rates of emigration from a certain nation do not match the rates of immigration to that country, overpopulation makes its way. The country becomes overly populated. Crowding of immigrants in certain parts of the world, results in an imbalance in the density of population.

4. Lack of Education: Illiteracy is another important cause of overpopulation. Those lacking education fail to understand the need to prevent excessive growth of population. They are unable to understand the harmful effects that overpopulation has. They are unaware of the ways to control population. Lack of family planning is commonly seen in the illiterate lot of the world. This is one of the major factors leading to overpopulation. Due to ignorance, they do not take to family planning measures, thus contributing to a rise in population.


Infertility Drugs 
Infertility drugs are medicines that help bring about pregnancy.

Purpose
Infertility is the inability of a man and woman to achieve pregnancy after at least a year of having regular sexual intercourse without any type of birth control. There are many possible reasons for infertility, and finding the most effective treatment for a couple may involve many tests to find the problem. For pregnancy to occur, the woman's reproductive system must release eggs regularly—a process called ovulation. The man must produce healthy sperm that are able to reach and unite with an egg. And once an egg is fertilized, it must travel to the woman's uterus (womb), become implanted and remain there to be nourished.

If a couple is infertile because the woman is not ovulating, infertility drugs may be prescribed to stimulate ovulation. The first step usually is to try a drug such as clomiphene. If that does not work, human chorionic gonadotropin (HCG) may be tried, usually in combination with other infertility drugs. 
Clomiphene and HCG may also be used to treat other conditions in both males and females.

Description
Clomiphene (Clomid, Serophene) comes in tablet form and is available only with a physician's prescription. Human chorionic gonadotropin is given as an injection, only under a physician's supervision.

Clomiphene citrate is used to increase the natural production of the hormones that stimulate ovulation in otherwise healthy women. When clomiphene is administered, the body produces higher levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), and gonadotropins. These hormones induce ovulation.

Human chorionic gonadotropin (hCG) is sold under many brand names including Gonic, Pregnyl and Profasi. This hormone stimulates the gonads in both men and women. In men, hCG increases androgen production. In women, it increases the levels of progesterone. Human chorionic gonadotropin can help stimulate ovulation in women.
Although some people believe that hCG can help lose weight, there is no evidence that this hormone offers any benefit in weight loss programs. It should not be used for this purpose.

A number of other natural and synthetic hormones are used to induce ovulation:

Urofollitropins (Fertinex) is a concentrated preparation of human hormones, while follitropin alfa (Gonal-F) and follitropin beta (Follistim) are human FSH preparations of recombinant DNA origin. Developments in this field are continuous. For example, in June 2004, the U.S. Food and Drug Administration (FDA) approved a follitropin beta injection in individualized doses for women to self-inject.

Menotropins (Pergonal, Humegon, Repronex) are given with human chorionic gonadotropin to stimulate ovulation in women and sperm production in men.

Recommended dosage:
The dosage may be different for different patients. The physician who prescribed the drug or the pharmacist who filled the prescription will recommend the correct dosage.
Clomiphene must be taken at certain times during the menstrual cycle and patients should follow directions exactly.



Medications are a regular and normal part of infertility treatments and the in vitro fertilization (IVF) procedure. These medications are used to prepare the body for treatment and to increase the probability that more healthy eggs are released from the ovaries. A reproductive specialist can evaluate your situation to determine the most appropriate medications for your situation. 







STIs


Sexually transmitted diseases (STDs) are diseases that are mainly passed from one person to another during sexual contact.
The term sexually transmitted infection (STI) is increasingly being used instead of STD, because some sexually transmitted infections, such as chlamydia, do not cause any pain or unpleasant symptoms such as blisters. Many people may never know that they have been infected unless they are tested in a clinic.     

1. Chlamydia is caused by the bacterium chlamydia trachomatis. This bacteria can infect the cervix in women and the urethra and rectum in both men and women. Occasionally chlamydia can also affect other parts of the body, including the throat and eyes.     

         
Chlamydia symptoms usually appear between 1 and 3 weeks after exposure but may not emerge until much later. Chlamydia is known as the ‘silent’ disease as in many people it produces no symptoms. It is estimated that 70-75% of women infected with chlamydia are asymptomatic (have no symptoms) and a significant proportion of men also have no symptoms. Those who do have symptoms of chlamydia may experience:

Women

  • An increase in vaginal discharge caused by an inflamed cervix;
  • the need to urinate more frequently, or pain whilst passing urine;
  • pain during sexual intercourse or bleeding after sex;
  • lower abdominal pains;
  • irregular menstrual bleeding.
Men
  • A white/cloudy and watery discharge from the penis that may stain underwear;
  • a burning sensation and/or pain when passing urine;
  • pain and swelling in the testicles.         
Treatment:
The treatment of chlamydia is simple and effective once the infection has been diagnosed. It consists of a short course of antibiotic tablets, which if taken correctly, can be more than 95 percent effective.

  • HSV-1 is acquired orally, causing cold sores.
  • HSV-2 is acquired during sexual contact and affects the genital area.




2. Genital herpes is caused by infection with herpes simplex virus (HSV). There are two types of HSV, HSV-1 and HSV-2, both of which belong to a wider group called Herpesviridae. Another well-known virus in this group is varicella zoster virus, which causes chicken-pox and shingles.
In general:

Once the initial outbreak of herpes is over, the virus hides away in the nerve fibres adjacent to the infection site, where it remains dormant, causing no symptoms. It is possible for the dormant virus to be 'reactivated' in some people, in which case it travels back down the nerve to the skin surface.


Symptom: If symptoms do occur, they will usually appear 2 to 7 days after exposure and last 2 to 4 weeks. Both men and women may have one or more symptoms, including:
  • Itching or tingling sensations in the genital or anal area;
  • small fluid-filled blisters that burst leaving small painful sores;
  • pain when passing urine over the open sores (especially in women);
  • headaches;
  • backache;
  • flu-like symptoms, including swollen glands or fever.
Treatment:   There is no cure for the herpes simplex virus and treatment is not essential, as an outbreak of genital herpes will usually clear up by itself. A doctor may however prescribe a course of antiviral tablets to reduce the severity of an outbreak. The antiviral tablets work by preventing the herpes simplex virus from multiplying.
Recurrences of genital herpes vary from person to person in frequency. Some will never experience an outbreak again, whilst others may have milder recurrences more than 6 times a year. Because these recurrent infections are milder, they often do not require treatment.



3.   Genital warts, caused by some types of HPV (human papillomavirus), can appear on the skin anywhere in the genital area as white or flesh-coloured, smooth, small bumps, or larger, fleshy, cauliflower-like lumps . There are more than 100 different subtypes of HPV, and around 30 of them specifically affect the genitals. Other HPV subtypes cause warts to grow on different parts of the body, such as the hands.
Not everyone infected with HPV will develop genital warts. Some people will be infected with a strain that does not produce warts, or they will remain asymptomatic (i.e. no warts will appear), even though the virus is present in the skin or mucous membranes around the genital area, or on the cervix in women. Those who do go on to develop genital warts will usually notice them 1 to 3 months after initial infection.

Symptom: If symptoms do appear then the infected person may notice pinkish/white small lumps or larger cauliflower-shaped lumps on the genital area. Genital warts can appear on or around the penis, the scrotum, the thighs or the anus. In women genital warts can develop around the vulva or inside the vagina and on the cervix. If a woman has warts on her cervix, this may cause slight bleeding or, very rarely, an unusual coloured vaginal discharge. Warts may occur singly or in groups. The warts may itch, but they are usually painless. Sometimes genital warts can be difficult to spot. In severe cases, it is possible for genital warts to spread from the genitals to the area around the anus, even if anal intercourse has not occurred.

Treatment:   There is no treatment that can completely eliminate genital warts once a person has been infected. Often outbreaks of genital warts will become less frequent over time, until the body naturally clears the virus and the warts disappear of their own accord. However, in some people the infection may linger.
A doctor can give patients various treatments to clear genital warts, but they may reappear even after treatment. Genital warts are caused by a virus, not a bacterium, so antibiotics will not get rid of them.


4. Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrheoae. Gonorrhea affects both men and women and can infect the cervix, urethra, rectum, anus and throat. Gonorrhea is one of the most common sexually transmitted diseases and the global gonorrhea statistics show that an estimated 62 million cases of gonorrhea occur each year, affecting more women than men. Gonorrhea is easily curable but if left untreated it can cause serious health problems such as pelvic inflammatory disease (PID), which can lead to abdominal pain and ectopic pregnancy in women. Untreated, gonorrhea can also lead to infertility, meningitis (bacterial infection of the membranes covering the brain and spinal cord) and septicaemia (commonly referred to as blood poisoning)

Symptom: Symptoms of gonorrhea infection may appear 1 to 14 days after exposure, although it is possible to be infected with gonorrhea and have no symptoms. Men are far more likely to notice symptoms as they are more apparent. It is estimated that nearly half of the women who become infected with gonorrhea experience no symptoms, or have non-specific symptoms such as a bladder infection.
Gonorrhea symptoms can include:

Women
  • A change in vaginal discharge; it may appear in abundance, change to a yellow or greenish colour, and develop a strong smell.
  • A burning sensation or pain whilst passing urine.
  • Irritation and/or discharge from the anus.
Men
  • A white or yellow discharge from the penis.
  • A burning sensation or pain whilst passing urine.
  • Irritation and/or discharge from the anus.         

Treatment: The patient will be given an antibiotic in tablet, liquid or injection form.

5. HIV stands for: Human Immunodeficiency Virus

HIV is a virus. Viruses such as HIV cannot grow or reproduce on their own, they need to infect the cells of a living organism in order to replicate (make new copies of themselves). The human immune system usually finds and kills viruses fairly quickly, but HIV attacks the immune system itself - the very thing that would normally get rid of a virus.

Often people who are infected with HIV don't have any symptoms at all. It is important to remember that a person who has HIV can pass on the virus immediately after becoming infected, even if they feel healthy. It's not possible to tell just by looking if someone has been infected with HIV.

With around 2.7 million people becoming infected with HIV in 2010, there are now an estimated 34 million people around the world who are living with HIV, including millions who have developed AIDS.
The condition that is referred to as AIDS is caused by HIV damaging the immune system cells until the immune system can no longer fight off other infections that it would usually be able to prevent.


Symptom: Some people experience a flu-like illness, develop a rash, or get swollen glands for a brief period soon after they become infected with HIV. However, these are also common symptoms of other less serious illnesses, and do not necessarily mean that a person has HIV. The only way to know for certain if someone is infected with HIV is for them to be tested.     

Treatment: Antiretroviral drugs keep the levels of HIV in the body at a low level, so that the immune system is able to recover and work effectively. Antiretroviral drugs enable many HIV positive people to live long and healthy lives.


Starting antiretroviral treatment for HIV infection involves commitment - drugs have to be taken every day, and for the rest of a person's life. Adhering to HIV treatment is important, particularly because not doing so increases the risk of drug resistance. Side effects to the HIV drugs can make adherence difficult, and are sometimes very severe. There are ways of reducing the impact of these side effects, but sometimes it is necessary to change to an alternative HIV treatment regime.     


6. 'Hepatitis' refers to viral infections that cause inflammation of the liver. Hepatitis A, B and C are the most common types. Each have different causes and symptoms.

a. Hepatitis A is the most common of the seven known types of viral hepatitis. Infection with the hepatitis A virus leads to inflammation of the liver, but complications are rarely serious.
 It is possible to experience mild or no symptoms whatsoever, but even if this is the case the person’s faeces will still be infectious to others. Many people who become infected with HAV will have symptoms that include:

  • A short, mild, flu-like illness;
  • nausea, vomiting and diarrhoea;
  • loss of appetite;
  • weight loss;
  • jaundice (yellow skin and whites of eyes, darker yellow urine and pale faeces);
  • itchy skin;
  • abdominal pain.
Patients should get plenty of rest and eat a nutritious diet. They should also ensure they do not spread HAV by washing their hands after using the toilet and before preparing food. Patients with more severe symptoms may be monitored in hospital for a short period.
There is no specific treatment for HAV and most people fight off the virus naturally, returning to full health within a couple of months. The doctor will advise avoiding alcohol and fatty foods as these can be hard for the liver to process and may exacerbate the inflammation.

b.  Hepatitis B is similar to hepatitis A in its symptoms, but is more likely to cause chronic long-term illness and permanent damage to the liver if not treated.

  Many people who become infected with HBV experience mild symptoms or no symptoms at all, but they may still carry the infectious virus and pass it on to others. When symptoms do appear they are similar to those of hepatitis A and may include:

  • A short, mild, flu-like illness;
  • nausea, vomiting and diarrhoea;
  • loss of appetite;
  • weight loss;
  • jaundice (yellow skin and whites of eyes, darker yellow urine and pale faeces);
  • itchy skin.
Antiviral medication is given as treatment to those with chronic symptoms to help prevent further liver damage. These medications may be injected or given in pill form. Examples are Interferon Alpha, Lamivudine and Baraclude. Treatment usually lasts 6 months, during which time the patient will be carefully monitored.
Regardless of whether the infection is producing symptoms or not, the patient will be advised to avoid alcohol, get plenty of rest and maintain a healthy diet.

c. Hepatitis C, like other forms of hepatitis, causes inflammation of the liver. The hepatitis C virus is transferred primarily through blood, and is more persistent than hepatitis A or B.
 Symptoms may include:

  • A short, mild, flu-like illness;
  • nausea and vomiting;
  • diarrhoea;
  • loss of appetite;
  • weight loss;
  • jaundice (yellow skin and whites of eyes, darker yellow urine and pale faeces);
  • itchy skin.
Treatment combines the antiviral drugs interferon and ribavirin. Although treatment has improved in recent years, the success rates vary depending on which genotype the patient has and how long they have had hepatitis C. In 2011, the FDA approved a new drug called Victrelis (for the treatment of the genotype 1 strain of hepatitis C). When taken alongside existing drugs, Victrelis cured more than 60 percent of patients in clinical trials compared to between 20-40 percent of patients when existing drugs were taken alone.Unlike other drugs for hepatitis C, Victrelis is a protease inhibitor, similar to those used to treat HIV. Adherence to this drug is essential to prevent drug resistance.          

7. Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidium. The infection is usually sexually transmitted, in which case it is called venereal syphilis. It may also be passed from an infected mother to her unborn child, in which case it is known as congenital syphilis.  
The symptoms of syphilis are the same in men and women. They can be mild and difficult to recognise or distinguish from other STDs. Symptoms may take up to 3 months to appear after initial infection. Syphilis is a slowly progressing disease that has several stages. The primary and secondary stages of syphilis are very infectious.

Primary stage of syphilis
One or more painless ulcers (know as chancres) appear at the place where the syphilis bacteria entered the body. On average, this will be 21 days after sexual contact with an infected person. Chancres may be difficult to notice and are highly infectious. The usual locations for chancres are:

  • On the vulva (outside the vagina) or on the cervix (neck of the womb) in women.
  • On the penis in men.
  • Around the anus and mouth (both sexes).     
Treatment:  Treatment for syphilis usually consists of a two-week course of intramuscular penicillin injections or, in some cases, antibiotic tablets or capsules. If the patient has had syphilis for less than a year then fewer doses will be needed. If the patient is allergic to any antibiotics, or if there is any possibility that they may be pregnant, then the doctor should be informed so that alternative medication can be prescribed. It is important that the full course of treatment is completed. If treatment is interrupted then it may be necessary to start again from the beginning.
         
 
If a patient is allergic to any antibiotics, or if there is a possibility they may be pregnant, it is important that the doctor is informed as this may affect which antibiotics are prescribed. Treatment must not be interrupted once a course of antibiotics has been started, otherwise it may be necessary to start again from the beginning.