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  1. #11
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    Hepatitis B

    Hepatitis B
    Source: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001324/
    Source: http://www.hepb.org/hepb/statistics.htm
    Source: http://gsk.com.my/pharma-antivirals-hepatitis.html

    Hepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV).

    Causes, incidence, and risk factors

    Hepatitis B infection can be spread through having contact with the blood, semen, vaginal fluids, and other body fluids of someone who already has a hepatitis B infection.

    Infection can be spread through:

    * Blood transfusions (not common in the United States)
    * Direct contact with blood in health care settings
    * Sexual contact with an infected person
    * Tattoo or acupuncture with unclean needles or instruments
    * Shared needles during drug use
    * Shared personal items (such as toothbrushes, razors, and nail clippers) with an infected person

    The hepatitis B virus can be passed to an infant during childbirth if the mother is infected.

    Most of the damage from the hepatitis B virus occurs because of the way the body responds to the infection. When the body's immune system detects the infection, it sends out special cells to fight it off. However, these disease-fighting cells can lead to liver inflammation.

    Symptoms

    After you first become infected with the hepatitis B virus:

    * You may have no symptoms
    * You may feel sick for a period of days or weeks
    * You may become very ill (called fulminant hepatitis)

    If your body is able to fight off the hepatitis B infection, any symptoms that you had should go away over a period of weeks to months.

    Some people's bodies are not able to completely get rid of the hepatitis B infection. This is called chronic hepatitis B.

    Many people who have chronic hepatitis B have few or no symptoms. They may not even look sick. As a result, they may not know they are infected. However, they can still spread the virus to other people.

    Symptoms may not appear for up to 6 months after the time of infection. Early symptoms may include:

    * Appetite loss
    * Fatigue
    * Fever, low-grade
    * Muscle and joint aches
    * Nausea and vomiting
    * Yellow skin and dark urine due to jaundice

    People with chronic hepatitis may have no symptoms, even though gradual liver damage may be occurring. Over time, some people may develop symptoms of chronic liver damage and cirrhosis of the liver.

    Signs and tests

    The following tests are done to identify and monitor liver damage from hepatitis B:

    * Albumin level
    * Liver function tests
    * Prothrombin time

    The following tests are done to help diagnose and monitor people with hepatitis B:

    * Antibody to HBsAg (Anti-HBs) -- a positive result means you have either had hepatitis B in the past, or have received a hepatitis B vaccine
    * Antibody to hepatitis B core antigen (Anti-HBc) -- a positive result means you had a recent infection or an infection in the past
    * Hepatitis B surface antigen (HBsAg) -- a positive result means you have an active infection
    * Hepatitis E surface antigen (HBeAg) -- a positive result means you have a hepatitis B infection and are more likely to spread the infection to others through sexual contact or sharing needles

    Patients with chronic hepatitis will need ongoing blood tests to monitor their status.

    Treatment

    Acute hepatitis needs no treatment other than careful monitoring of liver and other body functions with blood tests. You should get plenty of bed rest, drink plenty of fluids, and eat healthy foods.

    In the rare case that you develop liver failure, you may need a liver transplant. A liver transplant is the only cure in some cases of liver failure.

    Some patients with chronic hepatitis may be treated with antiviral medications or a medication called peginterferon. These medications can decrease or remove hepatitis B from the blood and reduce the risk of cirrhosis and liver cancer.

    Liver transplantation is used to treat severe, chronic hepatitis B liver disease.

    Patients with chronic hepatitis should avoid alcohol and should always check with their doctor or nurse before taking any over-the-counter medications or herbal supplements. This even includes medications such as acetaminophen, aspirin, or ibuprofen.

    See: Cirrhosis for information about treating more severe liver damage caused by hepatitis B.
    http://www.meteorforum.com/showthrea...sted=1#post229

    Expectations (prognosis)

    The acute illness usually goes away after 2 - 3 weeks. The liver usually returns to normal within 4 - 6 months in almost all patients who are infected.

    Some people develop chronic hepatitis.

    * Almost all newborns and about 50% of children who become infected with hepatitis B develop chronic hepatitis. Less than 5% of adults who are infected with the hepatitis B virus develop the chronic condition.
    * Chronic hepatitis B infection increases the risk for liver damage, including cirrhosis and liver cancer.
    * People who have chronic hepatitis B can transmit the infection. They are considered carriers of the disease, even if they do not have any symptoms.

    Hepatitis B is fatal in about 1% of cases.

    Complications

    There is a much higher rate of hepatocellular carcinoma in people who have chronic hepatitis B than in the general population.

    Other complications may include:

    * Chronic persistent hepatitis
    * Cirrhosis
    * Fulminant hepatitis, which can lead to liver failure and possibly death

    Calling your health care provider

    Call your health care provider if:

    * You develop symptoms of hepatitis B
    * Hepatitis B symptoms do not go away in 2 or 3 weeks, or new symptoms develop
    * You belong to a high-risk group for hepatitis B and have not yet received the HBV vaccine.

    Prevention

    All children should receive their first dose of the hepatitis B vaccine at birth, and complete the series of three shots by age 6 months. Children younger than age 19 who have not been vaccinated should receive "catch-up" doses.

    People who are at high risk, including health care workers and those who live with someone who has hepatitis B should get the hepatitis B vaccine.

    Infants born to mothers who either currently have acute hepatitis B, or who have had the infection should receive a special vaccination that includes hepatitis B immune globulin and a hepatitis B immunization within 12 hours of birth.

    Screening of all donated blood has reduced the chance of getting hepatitis B from a blood transfusion. Mandatory reporting of the disease allows state health care workers to track people who have been exposed to the virus. The vaccine is given to those who have not yet developed the disease.

    The hepatitis B vaccine or a hepatitis B immune globulin (HBIG) shot may help prevent hepatitis B infection if it is given within 24 hours of exposure.

    Lifestyle measures for preventing transmission of hepatitis B:

    * Avoid sexual contact with a person who has acute or chronic hepatitis B.
    * Use a condom and practice safe sex.
    * Avoid sharing personal items, such as razors or toothbrushes.
    * Do not share drug needles or other drug equipment (such as straws for snorting drugs).
    * Clean blood spills with a solution containing 1 part household bleach to 10 parts water.

    Statistics

    Most healthy adults (90%) who are infected will recover and develop protective antibodies against future hepatitis B infections. A small number (5-10%) will be unable to get rid of the virus and will develop chronic infections. Unfortunately, this is not true for infants and young children – 90% of infants and up to 50% of young children infected with hepatitis B will develop chronic infections. Therefore, vaccination is essential to protect infants and children.

    Hepatitis B is 100 times more infectious than the AIDS virus, yet it can be prevented with a safe and effective vaccine. For the 400 million people worldwide who are already chronically infected with hepatitis B, the vaccine is of no use. The future, however, is much brighter with the current advances in drug development and treatment options.

    Hepatitis B In the World

    * 2 billion people have been infected (1 out of 3 people).
    * 400 million people are chronically infected.
    * 10-30 million will become infected each year.
    * An estimated 1 million people die each year from hepatitis B and its complications.
    * Approximately 2 people die each minute from hepatitis B.









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  2. #12
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    Trichomoniasis

    Trichomoniasis
    Source:http://www.cdc.gov/std/trichomonas/s...homoniasis.htm
    Source:http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002307/

    Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis.
    Trichomoniasis is a common sexually transmitted disease (STD) that affects both women and men, although symptoms are more common in women.

    Causes, incidence, and risk factors

    Trichomoniasis is found worldwide. In the United States, the highest number of cases are seen in women between age 16 and 35. Trichomonas vaginalis is spread through sexual contact with an infected partner. This include penis-to-vagina intercourse or vulva-to-vulva contact. The parasite cannot survive in the mouth or rectum.

    The disease can affect both men and women, but the symptoms differ between the two groups. The infection usually does not cause symptoms in men and goes away on its own in a few weeks.

    Symptoms

    Women:

    Discomfort with intercourse
    Itching of the inner thighs
    Vaginal discharge (thin, greenish-yellow, frothy or foamy)
    Vaginal itching
    Vulvar itching or swelling of the labia
    Vaginal odor (foul or strong smell)

    Men:

    Burning after urination or ejaculation
    Itching of urethra
    Slight discharge from urethra

    Occasionally, some men with trichomoniasis may develop prostatitis or epididymitis from the infection.

    Signs and tests

    In women:

    A pelvic examination shows red blotches on the vaginal wall or cervix. A wet prep (microscopic examination of discharge) shows the infection-causing organisms in vaginal fluids. A pap smear may also diagnose the condition.

    In men:

    The disease can be hard to diagnose in men. Men are treated if the infection is diagnosed in any of their sexual partners. Men may also be treated if they have ongoing symptoms of urethral burning or itching despite treatment for gonorrhea and chlamydia.
    Treatment

    The antibiotic metronidazole is commonly used to cure the infection. A newer drug, called Tinidazole may be used.

    You should not drink alcohol while taking the medicine and for 48 hours afterwards. Doing so can cause severe nausea, abdominal pain, and vomiting.

    Avoid sexual intercourse until treatment has been completed. Sexual partners should be treated at the same time, even if they have no symptoms.

    Expectations (prognosis)

    With proper treatment, the outcome is likely to be excellent.
    Complications

    Long-term infection may cause changes in the tissue on the cervix. These changes may be seen on a routine Pap smear. In such cases, treatment should be started and the Pap smear repeated 3 to 6 months later.

    Treatment of trichomoniasis helps prevents the spread of the disease to sexual partners. Trichomoniasis is common among persons with HIV.

    Prevention

    A monogamous sexual relationship with a known healthy partner can help reduce the risk of sexually transmitted infections, including trichomoniasis.

    Other than total abstinence, condoms remain the best and most reliable protection against sexually transmitted infections. Condoms must be used consistently and correctly to be effective.

    How does trichomoniasis affect a pregnant woman and her baby?

    Pregnant women with trichomoniasis may have babies who are born early or with low birth weight (low birth weight is less than 5.5 pounds).













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  3. #13
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    Molluscum Contagiosum

    Molluscum Contagiosum
    Source :http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001829/
    Source: http://en.wikipedia.org/wiki/Molluscum_contagiosum

    Molluscum contagiosum is a viral skin infection that causes raised, pearl-like papules or nodules on the skin.

    Causes, incidence, and risk factors

    Molluscum contagiosum is caused by a virus that is a member of the poxvirus family. You can get the infection in a number of different ways.

    This is a common infection in children and occurs when a child comes into direct contact with a lesion. It is frequently seen on the face, neck, armpit, arms, and hands but may occur anywhere on the body except the palms and soles.

    The virus can spread through contact with contaminated objects, such as towels, clothing, or toys.

    The virus also spreads by sexual contact. Early lesions on the genitalia may be mistaken for herpes or warts but, unlike herpes, these lesions are painless.

    Persons with a weakened immune system (due to conditions such as AIDS) may have a rapidly worse case of molluscum contagiosum.

    Symptoms

    Typically, the lesion of molluscum begins as a small, painless papule that may become raised up to a pearly, flesh-colored nodule. The papule often has a dimple in the center. These papules may occur in lines, where the person has scratched. Scratching or other irritation causes the virus to spread in a line or in groups, called crops.

    The papules are about 2 - 5 millimeters wide. There is usually no inflammation and subsequently no redness unless you have been digging or scratching at the lesions.

    The skin lesion commonly has a central core or plug of white, cheesy or waxy material.

    In adults, the lesions are commonly seen on the genitals, abdomen, and inner thigh.

    Signs and tests

    Diagnosis is based on the appearance of the lesion and can be confirmed by a skin biopsy. The health care provider should examine the lesion to rule out other disorders and to determine other underlying disorders.

    Treatment

    Individual molluscum lesions may go away on their own and are reported as lasting generally from 6 to 8 weeks,[4] to 2 or 3 months.[5] However via autoinoculation, the disease may propagate and so an outbreak generally lasts longer with mean durations variously reported as 8 months,[4] to about 18 months,[6][7] and with a range of durations from 6 months to 5 years.[5][7]

    Treatment is often unnecessary[8] depending on the location and number of lesions, and no single approach has been convincingly shown to be effective. It should also be noted that treatments causing the skin on or near the lesions to rupture may spread the infection further, much the same as scratching does.[9] Nonetheless, treatment may be sought for the following reasons:
    Molluscum lesions on an arm.

    * Medical issues including:
    o Bleeding
    o Secondary infections
    o Itching and discomfort
    o Potential scarring
    o Chronic keratoconjunctivitis
    * Social reasons
    o Cosmetic
    o Embarrassment
    o Fear of transmission to others
    o Social exclusion

    Many health professionals recommend treating bumps located in the genital area to prevent them from spreading.[7] The virus lives only in the skin and once the growths are gone, the virus is gone and cannot be spread to others. When treatment has resulted in elimination of all bumps, the infection has been effectively cured and will not reappear unless the patient is reinfected.[10] In practice, it may not be easy to see all of the molluscum contagiosum bumps. Even though they appear to be gone, there may be some that were overlooked. If this is the case, one may develop new bumps by autoinoculation, despite their apparent absence.

    Expectations (prognosis)

    Molluscum contagiosum lesions may persist from a few months to a few years. These lesions ultimately disappear without scarring, unless there is excessive scratching, which may leave marks.

    Individual lesions usually disappear within about 2 - 3 months. Complete disappearance of all lesions generally occurs within about 6 - 18 months. The disorder may persist in immunosuppressed people.

    Complications

    Persistence, spread, or recurrence of lesions
    Secondary bacterial skin infections
    Calling your health care provider

    Call for an appointment with your health care provider if you have symptoms suggestive of molluscum contagiosum. Also call for an appointment with your health care provider if lesions persist or spread, or if new symptoms appear.

    Prevention

    Avoid direct contact with the skin lesions. Do not share towels with other people.

    Avoiding sex can also prevent molluscum virus and other STDs. You can also avoid STDs by having a monogamous sexual relationship with a partner known to be disease-free.

    Male and female condoms cannot fully protect you, as the virus can be on areas not covered by the condom. Nonetheless, condoms should still be used every time the disease status of a sexual partner is unknown. They reduce your chances of getting or spreading STDs. Use them with spermicide with nonoxynol 9.











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  4. #14
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    Lymphogranuloma

    Lymphogranuloma
    Source :http://www.urologychannel.com/std/lymphogranuloma.shtml
    Source: http://herpes-coldsores.com/std/lymphogranuloma.htm

    Lymphogranuloma Overview

    Lymphogranuloma venereum (LGV), also known as lymphogranuloma inguinale, tropical bubo, Nicholas-Favre disease, and sixth venereal disease, is an infection caused by a variety of the bacterium Chlamydia trachomatis. It primarily causes painful swelling of the lymph nodes located closest to the site of infection. If left untreated, it can cause serious tissue damage, scarring, rectal or intestinal blockages, and extreme swelling of the genitals (elephantiasis). In severe cases, it attacks the central nervous system.

    Incidence and Prevalence of Lymphogranuloma

    LGV is relatively rare in the United States and most industrialized countries, where it infects an average of 250 to 400 people a year, mostly men, between the ages of 15 and 24. Prevalence is highest in Southeast Asia, Africa, Central and South America, and the Caribbean, hence "tropical bubo."

    Causes of Lymphogranuloma

    LGV is spread by direct sexual contact with the genitals, rectum, or mouth. Once in the body, bacteria reproduce in the lymph nodes. It may be most closely associated with anal sex and men who have sex with men. Newborns can contract the disease from infected mothers during birth.

    Signs and Symptoms of Lymphogranuloma

    Sores resembling pimples or blisters may appear where the bacteria entered the body, but not always. They often heal quickly, without leaving a scar. Discharge from the penis or vagina is a common early stage symptom. These signs usually appear within 3 days to 1 month after exposure.

    Second-stage symptoms are more pronounced and generally begin 1 to 2 weeks after early-stage symptoms appear. The lymph nodes located closest to the site of infection, usually in the groin, swell and form a painful, pus-filled swelling (bubo). Buboes can grow as large as a lemon, and the skin over them may turn blue. They are usually accompanied by throbbing pain, fever, malaise, or headache. In about 30% of cases, the bubo breaks through the skin, drains continuously, remains open, and becomes infected by other bacteria. A burst bubo can take months to heal completely and often leaves a scar.

    Buboes may form near the throat, neck, anus, rectum, and cervix. Involvement of the rectum and anus can cause rectal discharge and cause the lining of the rectum to swell, bleed, and erode. If erosion spreads to the colon, the rectum may swell almost closed. Women may experience backache if buboes form on the cervix or in the upper vagina. Chronic inflammation of the lymph nodes can lead to genital elephantiasis, narrowing of the rectal passage (stricture), perirectal abscess, and abnormal rectal channels or tunnel-like lesions (fistulas).


    Lymphogranuloma Diagnosis

    Physicians typically diagnose LGV by visual observation and blood tests that identify bacteria and antibodies produced by the body to fight the infection. Blood tests also rule out or identify other STDs, such as herpes, syphilis, chancroid, and gonorrhea. A sample of the discharge may be taken to be cultured.

    Treatment for Lymphogranuloma

    A 3-week course of antibiotics, usually tetracycline, doxycycline, or erythromycin, is prescribed to kill bacteria. Buboes may remain after infection is cured and are usually surgically drained with a needle. Surgical repair of fistulas and erosion may be necessary. In cases of elephantiasis, plastic surgery may be helpful. Physicians routinely observe patients for about 6 months after treatment.










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  5. #15
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    Vulvovaginitis (Vaginitis)

    Vulvovaginitis (Vaginitis)

    Vulvovaginitis is inflammation or infection of the vulva and vagina.

    Causes, incidence, and risk factors

    Vulvovaginitis can affect women of all ages and is extremely common. It can be caused by bacteria, yeasts, viruses, and other parasites. Some sexually transmitted infections (STIs) can also cause vulvovaginitis, as can various chemicals found in bubble baths, soaps, and perfumes. Environmental factors such as poor hygiene and allergens may also cause this condition.

    Candida albicans, which causes yeast infections, is one of the most common causes of vulvovaginitis in women of all ages. Antibiotic use can lead to yeast infections by killing the normal antifungal bacteria that live in the vagina. Yeast infections typically cause genital itching and a thick, white vaginal discharge, and other symptoms. For more information see: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002480/

    Another cause of vulvovaginitis is bacterial vaginosis, an overgrowth of certain types of bacteria in the vagina. Bacterial vaginosis may cause a thin, grey vaginal discharge and a fishy odor.

    An STI called trichomonas vaginitis infection is another common cause. This infection leads to genital itching, a vaginal odor, and a heavy vaginal discharge, which may be yellow-grey or green in color.

    Bubble baths, soaps, vaginal contraceptives, feminine sprays, and perfumes can cause irritating itchy rashes in the genital area, while tight-fitting or nonabsorbent clothing sometimes cause heat rashes.

    Irritated tissue is more susceptible to infection than normal tissue, and many infection-causing organisms thrive in environments that are warm, damp, and dark. Not only can these factors contribute to the cause of vulvovaginitis, they frequently prolong the recovery period.

    A lack of estrogen in postmenopausal women can result in vaginal dryness and thinning of vaginal and vulvar skin, which may also lead to or worsen genital itching and burning.

    Some skin conditions can cause itching and chronic irritation of the vulvar area. Foreign bodies, such as lost tampons, can also cause vulvar irritation and itching and strong smelling discharge.

    Nonspecific vulvovaginitis (where specific cause cannot be identified) can be seen in all age groups, but it occurs most commonly in young girls before puberty. Once puberty begins, the vagina becomes more acidic, which tends to help prevent infections.

    Nonspecific vulvovaginitis can occur in girls with poor genital hygiene and is characterized by a foul-smelling, brownish-green discharge and irritation of the labia and vaginal opening. This condition is often associated with an overgrowth of a type of bacteria that is typically found in the stool. These bacteria are sometimes spread from the rectum to the vaginal area by wiping from back to front after using the bathroom.

    Sexual abuse should be considered in children with unusual infections and recurrent episodes of unexplained vulvovaginitis. Neisseria gonorrhoeae, the organism that causes gonorrhea, produces gonococcal vulvovaginitis in young girls who have sexual exposure. Gonorrhea-related vaginitis is considered a sexually transmitted illness. If lab tests confirm this diagnosis, young girls should be evaluated for sexual abuse.

    Symptoms

    * Irritation and itching of the genital area
    * Inflammation (irritation, redness, and swelling) of the labia majora, labia minora, or perineal area
    * Vaginal discharge
    * Foul vaginal odor
    * Discomfort or burning when urinating

    Signs and tests

    If you have been diagnosed with a yeast infection in the past, you can try treatment with over-the-counter products. However, if your symptoms do not completely disappear in about a week, contact your health care provider. Many other infections have similar symptoms.

    The health care provider will perform a pelvic examination. This may show red, tender areas on the vulva or vagina.

    A wet prep (microscopic evaluation of vaginal discharge) is usually done to identify a vaginal infection or overgrowth of yeast or bacteria. In some cases, a culture of the vaginal discharge may identify the organism causing the infection.

    A biopsy of the irritated area on the vulva may be recommended if there are no signs of infection.
    Treatment

    Treatment depends on what is causing the infection. Treatment may include:

    * Antibiotics taken by mouth or applied to the skin
    * Antifungal cream
    * Antibacterial cream
    * Cortisone cream
    * Antihistamine, if the irritation is due to an allergic reaction
    * Estrogen cream, if the irritation and inflammation is due to low levels of estrogen

    Proper cleansing is important and may help prevent irritation, particularly in those with infections caused by bacteria normally found in stool. Sitz baths may be recommended.

    It is often helpful to allow more air to reach the genital area. You can do this by:

    * Wearing cotton underwear (rather than nylon) or underwear that has a cotton lining in the crotch area. This increases air flow and decreases moisture.
    * Removing underwear at bedtime.

    Note: If a sexually transmitted infection is diagnosed, it is very important that any other sexual partners receive treatment, even if they do not have symptoms. If your sexual partner is infected but not treated, you risk becoming infected over and over again.

    Expectations (prognosis)

    Proper treatment of an infection is usually very effective.

    Complications

    * Discomfort that does not go away
    * Skin infection (from scratching)
    * Complications due to the cause of the condition (such as gonorrhea and candida infection)

    Prevention

    Use of a condom during sexual intercourse can prevent most sexually transmitted vaginal infections. Proper fitting and adequately absorbent clothing, combined with good hygiene of the genital area, also prevents many cases of noninfectious vulvovaginitis.

    Children should be taught how to properly clean the genital area while bathing or showering. Proper wiping after using the toilet will also help (girls should always wipe from the front to the back to avoid introducing bacteria from the rectum to the vaginal area).

    Hands should be washed thoroughly before and after using the bathroom.








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  6. #16
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    Pelvic Inflammatory Disease (PID)

    Pelvic Inflammatory Disease (PID)
    Source: http://www.cdc.gov/std/pid/stdfact-pid.htm

    What is PID?

    Pelvic inflammatory disease (PID) refers to infection of the uterus (womb), fallopian tubes (tubes that carry eggs from the ovaries to the uterus) and other reproductive organs that causes symptoms such as lower abdominal pain. It is a serious complication of some sexually transmitted diseases (STDs), especially chlamydia and gonorrhea. PID can damage the fallopian tubes and tissues in and near the uterus and ovaries. PID can lead to serious consequences including infertility, ectopic pregnancy (a pregnancy in the fallopian tube or elsewhere outside of the womb), abscess formation, and chronic pelvic pain.

    How common is PID?

    Each year in the United States, it is estimated that more than 750,000 women experience an episode of acute PID. Up to 10-15% of these women may become infertile as a result of PID. A large proportion of the ectopic pregnancies occurring every year are due to the consequences of PID.

    How do women get PID?

    PID occurs when bacteria move upward from a woman's vagina or cervix (opening to the uterus) into her reproductive organs. Many different organisms can cause PID, but many cases are associated with gonorrhea and chlamydia, two very common bacterial STDs. A prior episode of PID increases the risk of another episode because the reproductive organs may be damaged during the initial bout of infection.

    Sexually active women in their childbearing years are most at risk, and those under age 25 are more likely to develop PID than those older than 25. This is partly because the cervix of teenage girls and young women is not fully matured, increasing their susceptibility to the STDs that are linked to PID.

    The more sex partners a woman has, the greater her risk of developing PID. Also, a woman whose partner has more than one sex partner is at greater risk of developing PID, because of the potential for more exposure to infectious agents.

    Women who douche may have a higher risk of developing PID compared with women who do not douche. Research has shown that douching changes the vaginal flora (organisms that live in the vagina) in harmful ways, and can force bacteria into the upper reproductive organs from the vagina.

    Women who have an intrauterine device (IUD) inserted may have a slightly increased risk of PID near the time of insertion compared with women using other contraceptives or no contraceptive at all. However, this risk is greatly reduced if a woman is tested and, if necessary, treated for STDs before an IUD is inserted.

    What are the signs and symptoms of PID?

    Symptoms of PID vary from mild to severe. When PID is caused by chlamydial infection, a woman may be more likely to experience only mild symptoms even when serious damage is being done to her reproductive organs. Chlamydia can also cause fallopian tube infection without any symptoms. Because of vague symptoms, PID often goes unrecognized by women and their health care providers. Women who have symptoms of PID most commonly have lower abdominal pain. Other signs and symptoms include fever, unusual vaginal discharge that may have a foul odor, painful intercourse, painful urination, irregular menstrual bleeding, and pain in the right upper abdomen (rare).

    What are the complications of PID?

    Prompt and appropriate treatment can help prevent complications of PID, including permanent damage to the female reproductive organs. Infection-causing bacteria can silently invade the fallopian tubes, causing normal tissue to turn into scar tissue. This scar tissue blocks or interrupts the normal movement of eggs into the uterus. If the fallopian tubes are totally blocked by scar tissue, sperm cannot fertilize an egg, and the woman becomes infertile. Infertility also can occur if the fallopian tubes are partially blocked or even slightly damaged. Up to 10-15% of women with PID may become infertile, and if a woman has multiple episodes of PID, her chances of becoming infertile increase.

    In addition, a partially blocked or slightly damaged fallopian tube may cause a fertilized egg to remain in the fallopian tube. If this fertilized egg begins to grow in the tube as if it were in the uterus, it is called an ectopic pregnancy. As it grows, an ectopic pregnancy can rupture the fallopian tube causing severe pain, internal bleeding, and even death.

    Scarring in the fallopian tubes and other pelvic structures can also cause chronic pelvic pain (pain that lasts for months or even years). Women with repeated episodes of PID are more likely to suffer infertility, ectopic pregnancy, or chronic pelvic pain.

    How is PID diagnosed?

    PID is difficult to diagnose because the symptoms are often subtle and mild. Many episodes of PID go undetected because the woman or her health care provider fails to recognize the implications of mild or nonspecific symptoms. Because there are no precise tests for PID, a diagnosis is usually based on clinical findings. If symptoms such as lower abdominal pain are present, a health care provider should perform a physical examination to determine the nature and location of the pain and check for fever, abnormal vaginal or cervical discharge, and for evidence of gonorrheal or chlamydial infection. If the findings suggest PID, treatment is necessary.

    The health care provider may also order tests to identify the infection-causing organism (e.g., chlamydial or gonorrheal infection) or to distinguish between PID and other problems with similar symptoms. A pelvic ultrasound is a helpful procedure for diagnosing PID. An ultrasound can view the pelvic area to see whether the fallopian tubes are enlarged or whether an abscess is present. In some cases, a laparoscopy may be necessary to confirm the diagnosis. A laparoscopy is a surgical procedure in which a thin, rigid tube with a lighted end and camera (laparoscope) is inserted through a small incision in the abdomen. This procedure enables the doctor to view the internal pelvic organs and to take specimens for laboratory studies, if needed.

    What is the treatment for PID?

    PID can be cured with several types of antibiotics. A health care provider will determine and prescribe the best therapy. However, antibiotic treatment does not reverse any damage that has already occurred to the reproductive organs. If a woman has pelvic pain and other symptoms of PID, it is critical that she seek care immediately. Prompt antibiotic treatment can prevent severe damage to reproductive organs. The longer a woman delays treatment for PID, the more likely she is to become infertile or to have a future ectopic pregnancy because of damage to the fallopian tubes.

    Because of the difficulty in identifying organisms infecting the internal reproductive organs and because more than one organism may be responsible for an episode of PID, PID is usually treated with at least two antibiotics that are effective against a wide range of infectious agents. These antibiotics can be given by mouth or by injection. The symptoms may go away before the infection is cured. Even if symptoms go away, the woman should finish taking all of the prescribed medicine. This will help prevent the infection from returning. Women being treated for PID should be re-evaluated by their health care provider three days after starting treatment to be sure the antibiotics are working to cure the infection. In addition, a woman’s sex partner(s) should be treated to decrease the risk of re-infection, even if the partner(s) has no symptoms. Although sex partners may have no symptoms, they may still be infected with the organisms that can cause PID.

    Hospitalization to treat PID may be recommended if the woman (1) is severely ill (e.g., nausea, vomiting, and high fever); (2) is pregnant; (3) does not respond to or cannot take oral medication and needs intravenous antibiotics; (4) has an abscess in the fallopian tube or ovary (tubo-ovarian abscess); or (5) needs to be monitored to be sure that her symptoms are not due to another condition that would require emergency surgery (e.g., appendicitis). If symptoms continue or if an abscess does not go away, surgery may be needed. Complications of PID, such as chronic pelvic pain and scarring are difficult to treat, but sometimes they improve with surgery.

    How can PID be prevented?

    Women can protect themselves from PID by taking action to prevent STDs or by getting early treatment if they do get an STD.

    The surest way to avoid transmission of STDs is to abstain from sexual intercourse, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

    Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of chlamydia and gonorrhea.

    CDC recommends yearly chlamydia testing of all sexually active women age 25 or younger, older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners), and all pregnant women. An appropriate sexual risk assessment by a health care provider should always be conducted and may indicate more frequent screening for some women.

    Any genital symptoms such as an unusual sore, discharge with odor, burning during urination, or bleeding between menstrual cycles could mean an STD infection. If a woman has any of these symptoms, she should stop having sex and consult a health care provider immediately. Treating STDs early can prevent PID. Women who are told they have an STD and are treated for it should notify all of their recent sex partners so they can see a health care provider and be evaluated for STDs. Sexual activity should not resume until all sex partners have been examined and, if necessary, treated.








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  7. #17
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    Cirrhosis

    Cirrhosis

    Liver cirrhosis; Cryptogenic chronic liver disease

    Last reviewed: October 16, 2011.


    Cirrhosis is scarring of the liver and poor liver function. It is the final phase of chronic liver disease.


    Causes, incidence, and risk factors

    Cirrhosis is the end result of chronic liver damage caused by chronic liver diseases. Common causes of chronic liver disease in the United States include:
    •
    Hepatitis C infection (long-term infection)

    •
    Long-term alcohol abuse (see alcoholic liver disease)


    Other causes of cirrhosis include:
    •
    Autoimmune inflammation of the liver

    •
    Disorders of the drainage system of the liver (the biliary system), such as primary biliary cirrhosis and primary sclerosing cholangitis

    •
    Hepatitis B (long-term infection)

    •
    Medications

    •
    Metabolic disorders of iron and copper (hemochromatosis and Wilson's disease)

    •
    Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH)



    Symptoms

    Symptoms may develop gradually, or there may be no symptoms.

    When symptoms do occur, they can include:
    •
    Confusion or problems thinking

    •
    Impotence, loss of interest in sex, and breast development (gynecomastia) in men

    •
    Loss of appetite

    •
    Nausea and vomiting

    •
    Nosebleeds or bleeding gums

    •
    Pale or clay-colored stools

    •
    Small, red spider-like blood vessels on the skin

    •
    Swelling or fluid buildup of the legs (edema) and in the abdomen (ascites)

    •
    Vomiting blood or blood in stools

    •
    Weakness

    •
    Weight loss

    •
    Yellow color in the skin, mucus membranes, or eyes (jaundice)



    Signs and tests

    During a physical examination the health care provider may find:
    •
    An enlarged liver or spleen

    •
    Excess breast tissue

    •
    Expanded (distended) abdomen, as a result of too much fluid

    •
    Reddened palms

    •
    Red spider-like blood vessels on the skin

    •
    Small testicles

    •
    Widened (dilated) veins in the abdomen wall

    •
    Yellow eyes or skin (jaundice)


    Tests can reveal liver problems including:
    •
    Anemia (detected on a complete blood count test)

    •
    Clotting problems

    •
    Liver function problems (detected on liver function tests)

    •
    Low blood albumin


    The following tests may be used to evaluate the liver:
    •
    Computed tomography (CT) of the abdomen

    •
    Magnetic resonance imaging (MRI) of the abdomen

    •
    Endoscopy to check for abnormal veins in the esophagus or stomach

    •
    Ultrasound of the abdomen


    A liver biopsy confirms cirrhosis.

    Some patients will be screened for liver cancer. Your doctor will use a blood test to check for levels of alpha fetoprotein and will do an imaging test (ultrasound, MRI, or CT scan).


    Treatment

    All patients with cirrhosis can benefit from certain lifestyle changes, including:
    •
    Stop drinking alcohol.

    •
    Limit salt in the diet.

    •
    Eat a nutritious diet.

    •
    Get vaccinated for influenza, hepatitis A and hepatitis B, and pneumococcal pneumonia (if recommended by your doctor).

    •
    Tell your doctor about all prescription and nonprescription medications, and any herbs and supplements you take now or are thinking of taking.


    Other treatment options are available for the complications of cirrhosis:
    •
    Bleeding varices -- upper endoscopy with banding and sclerosis

    •
    Excess abdominal fluid (ascites) -- take diuretics, restrict fluid and salt, and remove fluid (paracentesis)

    •
    Coagulopathy -- blood products or vitamin K

    •
    Confusion or encephalopathy -- lactulose medication and antibiotics

    •
    Infections -- antibiotics


    A procedure called transjugular intrahepatic portosystemic shunt (TIPS) is sometimes needed for bleeding varices or ascites.

    When cirrhosis progresses to end-stage liver disease, patients may be candidates for a liver transplant.


    Support Groups

    You can often ease the stress of illness by joining a support group whose members share common experiences and problems. See liver disease - support group.


    Expectations (prognosis)

    Cirrhosis is caused by irreversible scarring of the liver. Once cirrhosis develops, it is not possible to heal the liver or return its function to normal. It is a serious condition that can lead to many complications.

    A gastroenterologist or liver specialist (hepatologist) should help evaluate and manage complications. Cirrhosis may result in the need for a liver transplant.


    Complications
    •
    Bleeding disorders (coagulopathy)

    •
    Buildup of fluid in the abdomen (ascites) and infection of the fluid (bacterial peritonitis)

    •
    Enlarged veins in the esophagus, stomach, or intestines that bleed easily (esophageal varices)

    •
    Increased pressure in the blood vessels of the liver (portal hypertension)

    •
    Kidney failure (hepatorenal syndrome)

    •
    Liver cancer (hepatocellular carcinoma)

    •
    Mental confusion, change in the level of consciousness, or coma (hepatic encephalopathy)



    Calling your health care provider

    Call your health care provider if:
    •
    You develop symptoms of cirrhosis


    Call your provider, go to the emergency room, or call the local emergency number (such as 911) if you have:
    •
    Abdominal or chest pain

    •
    Abdominal swelling or ascites that is new or suddenly becomes worse

    •
    A fever (temperature greater than 101 °F)

    •
    Diarrhea

    •
    New confusion or a change in alertness, or it gets worse

    •
    Rectal bleeding, vomiting blood, or blood in the urine

    •
    Shortness of breath

    •
    Vomiting more than once a day

    •
    Yellowing skin or eyes (jaundice) that is new or suddenly becomes worse



    Prevention

    Don't drink alcohol heavily. If you find that your drinking is getting out of hand, seek professional help.

    Measures for preventing the transmission of hepatitis B or C include:
    •
    Avoid sexual contact with a person who has acute or chronic hepatitis B or C.

    •
    Use a condom and practice safe sex.

    •
    Avoid sharing personal items, such as razors or toothbrushes.

    •
    Do not share drug needles or other drug paraphernalia (such as straws for snorting drugs).

    •
    Clean blood spills with a solution containing 1 part household bleach to 10 parts water.



    References
    1.Garcia-Tsao G, Lim JK; Members of Veterans Affairs Hepatitis C Resource Center Program. Management and treatment of patients with cirrhosis and portal hypertension: recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program. Am J Gastroenterol. 2009;104:1802-1829.
    2.Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 156.
    3.Mehta G, Rothstein KD. Health maintenance issues in cirrhosis. Med Clin North Am. 2009;93:901-915.


    Review Date: 10/16/2011.

    Reviewed by: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.










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  8. #18
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    Hepatitis A

    Hepatitis A
    Hepatitis A (formerly known as infectious hepatitis and epidemical virus) is an acute infectious disease of the liver caused by the hepatitis A virus (Hep A),[1] an RNA virus, usually spread the fecal-oral route; transmitted person-to-person by ingestion of contaminated food or water or through direct contact with an infectious person. Tens of millions of individuals worldwide are estimated to become infected with Hep A each year.[2] The time between infection and the appearance of the symptoms (the incubation period) is between two and six weeks and the average incubation period is 28 days.[3]

    In developing countries, and in regions with poor hygiene standards, the incidence of infection with this virus is high[4] and the illness is usually contracted in early childhood. As incomes rise and access to clean water increases, the incidence of HAV decreases.[5] Hepatitis A infection causes no clinical signs and symptoms in over 90% of infected children and since the infection confers lifelong immunity, the disease is of no special significance to those infected early in life. In Europe, the United States and other industrialized countries, on the other hand, the infection is contracted primarily by susceptible young adults, most of whom are infected with the virus during trips to countries with a high incidence of the disease[3] or through contact with infectious persons.

    HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease. However, 10–15% of patients might experience a relapse of symptoms during the 6 months after acute illness. Acute liver failure from Hepatitis A is rare (overall case-fatality rate: 0.5%). The risk for symptomatic infection is directly related to age, with >80% of adults having symptoms compatible with acute viral hepatitis and the majority of children having either asymptomatic or unrecognized infection.[6] Antibody produced in response to HAV infection persists for life and confers protection against reinfection. The disease can be prevented by vaccination, and hepatitis A vaccine has been proven effective in controlling outbreaks worldwide.[3]


    Signs and symptoms

    Early symptoms of hepatitis A infection can be mistaken for influenza, but some sufferers, especially children, exhibit no symptoms at all. Symptoms typically appear 2 to 6 weeks, (the incubation period), after the initial infection.[7]

    Symptoms usually last less than 2 months, although some people can be ill for as long as 6 months.:[8]
    Fatigue
    Fever
    Abdominal pain
    Nausea
    Appetite loss
    Jaundice, a yellowing of the skin or whites of the eyes
    Bile is removed from blood stream and excreted in urine, giving it a dark amber colour
    Clay-coloured feces


    Virology



    Hepatitis A
    Electron micrograph of hepatitis A virions.

    Virus classification
    Group:

    Group IV ((+)ssRNA)

    Family:
    Picornaviridae

    Genus:
    Hepatovirus

    Species:
    Hepatitis A virus

    Following ingestion, HAV enters the bloodstream through the epithelium of the oropharynx or intestine.[9] The blood carries the virus to its target, the liver, where it multiplies within hepatocytes and Kupffer cells (liver macrophages). Virions are secreted into the bile and released in stool. HAV is excreted in large quantities approximately 11 days prior to appearance of symptoms or anti-HAV IgM antibodies in the blood. The incubation period is 15–50 days and mortality is less than 0.5%. Within the liver hepatocytes the RNA genome is released from the protein coat and is translated by the cell's own ribosomes. Unlike other members of the Picornaviruses this virus requires an intact eukaryote initiating factor 4G (eIF4G) for the initiation of translation.[10] The requirement for this factor results in an inability to shut down host protein synthesis unlike other picornaviruses. The virus must then inefficiently compete for the cellular translational machinery which may explain its poor growth in cell culture. Presumably for this reason the virus has strategically adopted a naturally highly deoptimized codon usage with respect to that of its cellular host. Precisely how this strategy works is not quite clear yet.

    There is no apparent virus-mediated cytotoxicity presumably because of the virus' own requirement for an intact eIF4G and liver pathology is likely immune-mediated.

    Structure

    The Hepatitis virus (HAV) is a Picornavirus; it is non-enveloped and contains a single-stranded RNA packaged in a protein shell.[11] There is only one serotype of the virus, but multiple genotypes exist.[12] Codon use within the genome is biased and unusually distinct from its host. It also has a poor internal ribosome entry site[13] In the region that codes for the HAV capsid there are highly conserved clusters of rare codons that restrict antigenic variability.[14]


    Transmission

    The virus spreads by the fecal-oral route and infections often occur in conditions of poor sanitation and overcrowding. Hepatitis A can be transmitted by the parenteral route but very rarely by blood and blood products. Food-borne outbreaks are not uncommon,[15] and ingestion of shellfish cultivated in polluted water is associated with a high risk of infection.[16] Approximately 40% of all acute viral hepatitis is caused by HAV.[9] Infected individuals are infectious prior to onset of symptoms, roughly 10 days following infection. The virus is resistant to detergent, acid (pH 1), solvents (e.g., ether, chloroform), drying, and temperatures up to 60 °C. It can survive for months in fresh and salt water. Common-source (e.g., water, restaurant) outbreaks are typical. Infection is common in children in developing countries, reaching 100% incidence, but following infection there is life-long immunity. HAV can be inactivated by: chlorine treatment (drinking water), formalin (0.35%, 37 °C, 72 hours), peracetic acid (2%, 4 hours), beta-propiolactone (0.25%, 1 hour), and UV radiation (2 μW/cm2/min).


    http://en.wikipedia.org/wiki/Hep_a
    you can read more about this on the link.











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  9. #19
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    Urinary Tract Infection (UTI)

    Urinary Tract Infection (UTI)
    UTI is not a type of STD



    Introduction
    Urinary tract infection (UTI) - http://www.mayoclinic.com/health/uri...ection/DS00286

    A urinary tract infection (UTI) is an infection that begins in your urinary system. UTIs limited to your bladder can be painful and annoying. But serious consequences can occur if the infection spreads to your kidneys.

    Women are most at risk of developing a UTI. In fact, half of all women will develop a UTI during their lifetimes, and many will experience more than one.

    The urinary system is composed of the kidneys, ureters, bladder and urethra. All play a role in removing waste from your body. The kidneys, a pair of bean-shaped organs in your upper posterior abdomen, filter waste from your blood. Tubes called ureters carry urine from your kidneys to your bladder, where it is stored until it exits the body through the urethra. All of these components can become infected, but most infections involve the lower tract — the urethra and the bladder.

    Antibiotics are the typical treatment for urinary tract infections. But you can take steps to reduce your chance a getting a UTI in the first place.

    Signs and symptoms
    Urinary tract infection (UTI) - http://www.mayoclinic.com/health/uri...ection/DS00286

    Not everyone with a UTI develops recognizable signs and symptoms, but most people have some. These can include:

    * A strong, persistent urge to urinate
    * A burning sensation when urinating
    * Passing frequent, small amounts of urine
    * Blood in the urine (hematuria) or cloudy, strong-smelling urine

    Each type of UTI may result in more specific signs and symptoms, depending on which part of your urinary tract is infected:

    * Acute pyelonephritis. Infection of your kidneys may occur after spreading from an infection in your bladder. Kidney infection can cause upper back and flank pain, high fever, shaking chills, and nausea or vomiting.
    * Cystitis. Inflammation or infection of your bladder may result in pelvic pressure, lower abdomen discomfort, frequent, painful urination and strong-smelling urine.
    * Urethritis. Inflammation or infection of the urethra leads to burning with urination. In men, urethritis may cause penile discharge.

    Causes
    Urinary tract infection (UTI) - http://www.mayoclinic.com/health/uri...ection/DS00286

    Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. The urinary system has infection-fighting properties that inhibit the growth of bacteria and is designed to keep out such microscopic invaders. However, certain factors increase the chances that bacteria will enter the urinary tract, take hold and multiply into a full-blown infection.

    Having bacteria in the urine doesn't always signify an infection. Some people, especially older adults, may have bacteria in the urine without any signs or symptoms of infection. This condition, known as asymptomatic bacteriuria, doesn't need treatment.

    Cystitis may occur in women after sexual intercourse. But even girls and women who aren't sexually active are susceptible to lower urinary tract infections because the anus is so close to the female urethra. Most cases of cystitis are caused by Escherichia coli (E. coli), a species of bacteria commonly found in the gastrointestinal tract.

    In urethritis, the same organisms that infect the kidney and bladder can infect the urethra. In addition, because of the female urethra's proximity to the vagina, sexually transmitted diseases (STDs), such as herpes simplex virus and chlamydia, also are possible causes of urethritis.

    In men, urethritis often is the result of bacteria acquired through sexual contact. The majority of such infections are caused by gonorrhea and chlamydia.








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  10. #20
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    Bad Laws Crippling Global AIDS Response, Says UN

    10 July 2012
    Bad laws crippling global AIDS response, says UN
    by George Atkinson

    An independent body of global leaders, health and legal experts convened by the United Nations Development Programme says that punitive laws and human rights abuses are costing lives, wasting money and stifling the global AIDS response. The Global Commission on HIV and the Law based its new report on extensive research and first-hand accounts from people in 140 countries.

    "Bad laws should not be allowed to stand in the way of effective HIV responses," said Helen Clark, United Nations Development Programme Administrator, citing laws that criminalise and dehumanise populations at the highest risk of HIV.

    Specifically, the report identifies the following areas of concern:


    In over 60 countries, it is a crime to expose another person to HIV. To date, more than 600 HIV-positive people across 24 countries have been convicted of such crimes. These laws and practices discourage people from seeking an HIV test and disclosing their status.
    More than 70 countries criminalize same-sex sexual activity. Iran and Yemen impose the death penalty for sexual acts between men; Jamaica and Malaysia punishes homosexual acts with lengthy imprisonment. These laws make it difficult to prevent HIV amongst those most vulnerable to infection.
    The criminalization of proven harm reduction services (e.g. injecting rooms, needle exchanges) for injecting drug users.
    The legal environment in many countries exposes sex workers to violence and results in their economic and social exclusion. It also prevents them from accessing essential HIV prevention and care services.
    Laws and customs that disempower women and girls, from genital mutilation to lack of legislation against marital rape.
    Laws and policies that deny young people access to sex education.

    "Too many countries waste vital resources by enforcing archaic laws that ignore science and perpetuate stigma," said former President of Brazil Fernando Henrique Cardoso, who chairs the Commission. "Now, more than ever, we have a chance to free future generations from the threat of HIV. We cannot allow injustice and intolerance to undercut this progress, especially in these tough economic times."









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