INDEX . Certificate . Acknowledgement . History . Introduction of STD’s . Defination of STD’s . Major types of STD’s . Signs & Symptoms . Causes & Risk factors o on Dn UV FPF WN . Diagnosis 10. Treatment 11. Prevention 12. Medical Prescription 13. Case studies 14. Conclusion 15. BibliographyHISTORY The first well-recorded European outbreak of what is now known as syphilis occurred in 1494 when it broke out among French troops besieging Naples in the ttalian War of 1494-98." The disease may have originated from the Columbian Exchange.™From Naples, the disease swept across Europe, killing more than five million people.” As Jared Diamond describes it, "WIhen syphilis was first definitely recorded in Europe in 1495, its pustules often covered the body from the head to the knees, caused flesh to fall from people's faces, and led to death within a few months,” rendering it far more fatal than itis today. Diamond concludes,”[Bly 1546, the disease had evolved into the disease with the symptoms so well known to us today,"”"Gonorrhoeae is, recorded at least up to 700 years ago and associated with a district in Paris formerly known as “Le Clapiers*. This is where the prostitutes were to be found at that time." Prior to the invention of modern medicines, sexually transmitted diseases were generally incurable, and treatment was limited to treating the symptoms of the disease. The first voluntary hospital for venereal diseases was founded in 1746 at London Lock Hospital 2 Treatment was not always voluntary: in the second half of the 19th century, the Contagious Diseases Acts were used to arrest suspected prostitutes. In 1924, a number of states concluded the Brussols Agreement, whereby states agreed to provide free or low-cost medical treatment at ports for merchant seamen with venereal diseases. The first effective treatment for a sexually transmitted disease was salvarsan, a treatment for syphilis. With the discovery of antibollcs, a large number of sexually transmitted diseases became easily curable, and this, combined with effective public health campaigns against STDs, led to a public perception during the 1960s and 1970s that they have ceased to be a serious medical threat. During this period, the importance of contact tracing in treating STIs was recognized. By tracing the sexual partners of infected individuals, testing them for infection, treating the infected and tracing their contacts in turn, STI clinics could effectively suppress infections in the general population. In the 1980s, first genital herpes and then AIDS emerged into the public consciousness as sexually transmitted diseases that could not be cured by modern medicine. AIDS in particular hasa long asymptomatic period—during which time HIV (the human immunodeficiency virus, which causes AIDS) can replicate and the disease can be transmitted to others—followed by a symptomatic period, which loads rapidly to death unless treated. HIV/AIDS. entered the United States from Haiti in about 1969." Recognition that AIDS threatened a global pandemic led to public information campaigns and the development of treatments that allow AIDS to be managed by suppressing the replication of HIV for as long as possible. Contact tracing continues to be an important measure, even when diseases are incurable, as it helps to contain infection.INTRODUCTION ‘Sexually transmitted infections (STI), also referred to as sexually transmitted diseases (STD) and venereal diseases (VD), are infections that are commonly spread by sex, especially vaginal intercourse, anal sex or oral sex. Most STIs initially do not cause symptoms.” This results in a greater risk of passing the disease on to others." Symptoms and signs of disease may include vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain. STIs acquired before or during birth may result in poor outcomes for the baby. Some STis may cause problems with the ability to get pregnant. More than 30 different bacteria, viruses, and parasites can cause ST's." Bacterial STIs include chlamydia, gonorrhea, and syphilis among others. Viral STIs include genital herpes, HIV/AIDS, and genital warts among others. Parasitic STis include trichomoniasis among others. While usually spread by sex, some STIs can also be spread by non-semyal contact with contaminated blood and tissues, breastfeeding, or during childbirth." STI diagnostic tests are easily available in the developed world, but this is often not the case in the developing world The most effective way of preventing STIs is by not having sex. Some vaccinations may also decrease the risk of certain infections including hepatitis B and some types of HPV."' Safer sex practices such as use of condoms, having a smaller number of sexual partners, and being in a relationship where each person only has sex with the other also decreases the risk."*! Circumeision in males may be effective to prevent some infections." Most STIs are treatable or curable." Of the most common infections, syphilis, gonorrhea, chlamydia, trichomoniasis are curable, while herpes, hepatitis B, HIV/AIDS, and HPV are treatable but not curable. Resistance to certain antibiotics is developing among some organisms such as gonorrhea. In 2015, about 1.1 billion people had STIs other than HIV/AIDS." About 500 million were infected with either syphilis, gonorrhea, chlamydia or trichomoniasis." At least an additional 530 milion people have genital herpes and 290 million women have human papillomavirus." STIs other than HIV resulted in 108,000 deaths in 2015." In the United States there were 19 million new cases of sexually transmitted infections in 2010." Historical documentation of STIs date back to at least the Ebers papyrus around 1550 BC and the Old Testament.” There is often shame and stigma associated with these infections.” The term sexually transmitted infection is generally preferred over sexually transmitted disease or venereal disease, as it includes those who do not have symptomatic disease." =>) ze => =eDEFINATION Sexually transmitted diseases (STDs), or sexually transmitted infections (STis), are generally acquired by sexual contact. The organisms that cause sexually transmitted diseases may pass from person to person in blood, semen, or vaginal and other bodily fluids. ‘Sometimes these infections can be transmitted nonsexually, such as from mother to infant during pregnancy or childbirth, or through blood transfusions or shared needles. Its possible to contract sexually transmitted diseases from people who seem perfectly healthy, and who may not even be aware of the infection. STDs don't always cause symptoms, which is one of the reasons experts prefer the term “sexually transmitted infections” to "sexually transmitted diseases.”MAIN TYPES ¥ Chlamydia: Chlamydia is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis. In women, symptoms may include abnormal vaginal discharge, burning during urination, and bleeding in between periods, although most women do not experience any symptoms.[46] Symptoms in men include pain when urinating, and abnormal discharge from their penis.[47] THE EFFECTS Y Gonorrhea: Gonorrhea can infect the genitals, rectum, mouth, throat, and eyes.[9] In bad cases, it can spread through the blood to infect the body's joints. In the worst cases, it can spread through the blood and infect the heart (causing endocarditis, an infection of the heart's valvesor the spinal cord (causing meningitis). —— GONORRHEA ——— pa F A fi FE ho & “x i a>Y Syphilis: Syphilis can cause many serious problems if it is not treated. It makes a person much more likely to get HIV, because it causes sores on the genitals that make it easier for HIV (and other STDs) to get spread.{10] After a few years, if people with syphilis do not get treated, they can have serious problems with the organs in their body. Eventually - without treatment - syphilis infects the brain and causes death. HIV causes the immune system - the system in the body that is supposed to fight off infection - to not work as well as it should. This makes people with HIV more likely to get infections and some other diseases, like some cancers. HIV is the virus that causes AIDS. ¥ HsV[Herpes simplex virus]: The herpes simplex virus (HSV) causes genital herpes. Genital herpes can cause painful blisters on the genitals and anus. Herpes can also cause sores on the mouth." There is no cure for herpes.)v Human papilloma virus: There are about 40 different kinds of HPV that can be spread through sex and affectthe anus and genitals.'"! Examples of diseases that HPV can cause include: + Genital warts?! + Cancers of the anus, vagina, penis, mouth, or throat) + Cervical cancer (over 70% of cervical cancers - 7 cases out of every 10 - are caused by HPV) : hepatitis A, hepatitis B, and hepatitis C. Hepatitis A causes a short-term liver infection. It can be spread by having sex, though this is not the most common way to get hepatitis A."*! Hepatitis B and hepatitis C cause much more serious, long-lasting liver problems. Both can cause very bad liver disease, like cirrhosis, and death. They are more likely than hepatitis A to be spread by having sex.SIGNS & SYMPTOMS ‘Sexually transmitted infections (STis) can have a range of signs and symptoms, including no symptoms. That's why they may go unnoticed until complications occur or a partner is diagnosed, Signs and symptoms that might indicate an STI include: + Sores or bumps on the genitals or in the oral or rectal area + Painful or buming urination + Discharge from the penis + Unusual or odd-smelling vaginal discharge + Unusual vaginal bleeding + Pain during sex + Sore, swollen lymph nodes, particularly in the groin but sometimes more widespread + Lower abdominal pain + Fever + Rash over the trunk, hands or feet ‘Signs and symptoms may appear a few days after exposure, or it may take years before you have any noticeable problems, depending on the organism. When to see a doctor See a doctor immediately if: + You are sexually active and may have been exposed to an STI + You have signs and symptoms of an STI Make an appointment with a doctor: + When you consider becoming sexually active or when youre 21 — whichever comes first. + Before you start having sex with a new partnerCAUSES & RISK FACTORS 1. Causes ‘Sexually transmitted infections can be caused by: + Bacteria (gonorrhea, syphilis, chlamydia) + Parasites (trichomoni is) + Viruses (human papillomavirus, genital herpes, HIV) ‘Sexual activity plays a role in spreading many other infectious agents, although it's possible to be infected without sexual contact. Examples include the hepatitis A, B and C viruses, shigella, and Giardia intestinalis. 2. Risk factors Anyone who is sexually active risks exposure to a sexually transmitted infection to some degree. Factors that may increase that risk include: + Having unprotected sex. Vaginal or anal penetration by an infected partner who isnit wearing a latex condom significantly increases the risk of getting an STL Improper or inconsistent use of condoms can also increase your risk. Oral sex may be less risky, but infections can still be transmitted without a latex condom or dental dam. Dental dams — thin, square pieces of rubber made with latex or silicone — prevent skin-to-skin contact. + Having sexual contact with multiple partners. The more people you have sexual contact with, the greater your risk. This is true for concurrent partners as well as monogamous consecutive relationships. + Having a history of STIs. Having one STI makes it much easier for another STI to take hold. + Anyone forced to have sexual intercourse or sexual activity. Dealing with rape or assault can be difficult, but it's important to be seen as soon as possible. Screening, treatment and emotional support can be offered.Abusing alcohol or using recreational drugs. Substance abuse can inhibit your judgment, making you more willing to participate in risky behaviors. Injecting drugs. Needle sharing spreads many serious infections, including HIV, hepatitis B and hepatitis C. Being young. Half of STIs occur in people between the ages of 15 and 24. Men who request prescriptions for drugs to treat erectile dysfunction. Men who ask their doctors for prescriptions for certain drugs — such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra) — have higher rates of STIs. Be sure you are up to date on safe sex practices if you ask your doctor for one of these medications. Transmission from mother to infant Certain STls — such as gonorthea, chlamydia, HIV and syphilis — can be passed from an infected mother to her child during pregnancy or delivery. STIs in infants can cause serious problems and may be fatal. All pregnant women should be screened for these infections and treated. Possible complications include: Pebic pain Pregnancy complications Eye inflammation Arthritis, Pehic inflammatory disease Infertility Heart disease Certain cancers, such as HPV-associated cervical and rectal cancersDIAGNOSIS + Blood tests. Blood tests can confirm the diagnosis of HIV or later stages of syphilis. + Urine samples. Some STis can be confirmed with a urine sample. + Fluid samples. if you have active genital sores, testing fluid and samples from the sores may be done to diagnose the type of infection. Laboratory tests of material from a genital sore or discharge are used to diagnose some STs. + Pregnant women. Screening for HIV, hepatitis B, chlamydia and syphilis generally takes place at the first prenatal visit for all pregnant women. Gonorrhea and hepatitis C screening tests are recommended at least once during pregnancy for women at high risk of these infections. Women under age 25 who are sexually active. All sexually active women under age 25 should be tested for chlamydia infection. The chlamydia test uses a sample of urine or vaginal fluid you can collect yourself. Some experts recommend repeating the chlamydia test three months after you've had a positive test and been treated. + Men who have sex with men. Compared with other groups, men who have sex with men run a higher risk of acquiring STIs. Many public health groups recommend annual or more frequent STI screening for these men. Regular tests for HIV, syphilis, chlamydia and gonorrhea are particularly important. Evaluation for hepatitis B also may be recommended. + People with HIV. If you have HIV, it dramatically raises your risk of catching other STs. Experts recommend immediate testing for syphilis, gonorrhea, chlamydia and herpes after being diagnosed with HIV. People with HN’ should also be screened for hepatitis C. + Women with HIV may develop aggressive cervical cancer, so they should have a Pap test within a year of being diagnosed with HIV, and then again six months later. + Everyone. The one STI screening test suggested for everyone ages 13 to 64 is a blood or saliva test for human immunodeficiency virus (HIV), the virus that causes AIDS.TREATMENT Treatment usually consists of one of the following, depending on the infection: Antibiotics. Antibiotics, often ina single dose, can cure many sexually transmitted bacterial and parasitic infections, including gonothea, syphilis, chlamydia and trichomoniasis. Typically, youll be treated for gonorthea and chlamydia at the same time because the two infections often appear together. ‘Once you start antibiotic treatment, it's crucial to follow through. if you don't think youll be able to take medication as prescribed, tell your doctor. A shorter, ‘simpler treatment regimen may be available. ln addition, its important to abstain from sex until you've completed treatment and any sores have healed. Antiviral drugs. You'll have fewer herpes recurrences if you take daily suppressive therapy with a prescription antiviral drug. Antiviral drugs lessen the risk of infection, but its stil possible to give your partner herpes. Antiviral drugs can keep HIV infection in check for many years. But the virus persists and can still be transmitted, though the risk is lower. ‘The sooner you start treatment, the more effective it is. Once you start treatment — if you take your medications exactly as directed — it's possible to lower your virus count to nearly undetectable levels. if youve had an STI, ask your doctor how long after treatment you need to be retested. Doing so ensures that the treatment worked and that you haven't been reinfected. If tests show that you have an STI, your sex partners — including your current partners and any other partners you've had over the last three months to one year — need to be informed so that they can get tested and treated if infected. Each state has different requirements, but most mandate that certain STIs be reported to the local or state health department. Public health departments frequently employ trained disease intervention specialists who can help with partner notification and treatment referrals.PREVENTION There are several ways to avoid or reduce your risk of sexually transmitted infections. + Abstain. The most effective way to avoid STIs is to abstain from sex. + Stay with one uninfected partner. Another reliable way of avoiding STIs is to stay in a long-term mutually monogamous relationship with a partner who isn't infected. + Wait and verify. Avoid vaginal and anal intercourse with new partners until you have both been tested for STis. Oral sex is less risky, but use a latex condom or dental dam — a thin, square piece of rubber made with latex or silicone — to prevent direct contact between the oral and genital mucous membranes. Keep in mind that no good screening test exists for genital herpes for either sex, and human papillomavirus (HPV) screening isn't available for men. + Get vaccinated. Getting vaccinated early, before sexual exposure, is also effective in preventing certain types of STIs. Vaccines are available to prevent human papillomavirus (HPV), hepatitis A and hepatitis B. ‘The Centers for Disease Control and Prevention (CDC) recommends the HPV vaccine for girls and boys ages 11 and 12. f not fully vaccinated at ages 11 and 12, the CDC recommends that girls and women through age 26 and boys and men through age 26 receive the vaccine. The hepatitis B vaccine is usually given to newboms, and the hepatitis A vaccine is recommended for 1-year-olds. Both vaccines are recommended for people who aren't already immune to these diseases and for those who are at increased risk of infection, such as men who have sex with men and IV drug users. + Use condoms and dental dams consistently and correctly. Use a new latex condom or dental dam for each sex act, whether oral, vaginal or anal. Never use an oil-based lubricant, such as petroleum jelly, with a latex condom or dental dam,Condoms made from natural membranes are not recommended because theyre not as effective at preventing STIs. Keep in mind that while condoms reduce your risk of exposure to most STIs, they provide a lesser degree of protection for STIs involving exposed genital sores, such as humanCASE STUDIES CASE STUDY-1 Name of patient: Mr.Lallu Yadav Date: 12-12-2012 Age: 40 Name of doctor: Dr.Romeo Smith symptoms: Suffering from Urethritis[chlamydia] caused by Chlamydia Trachomatis for 7 months. Diagnosis: Urine test of chlamydia & physical examination including genital & rectum. Precautions Advised: Barrier methods like condoms, fem shields, cervical cap etc, are used to prevent these type of STD’s & follow safer sex practices. Drink more & more water to increase the emission of urine. Keep the area around the opening of the urethra clean. Treatment: Antibiotics like Tetra & doxycylins are used.CASE STUDY-2 Name of patient: Mrs.Sonam Gupta Date: 11-11-2011 Age: 30 Name of doctor: Dr.David Fernandis symptoms: Suffering from Gonorrhea for 4 months & due to this a pus filled discharge is mostly observed along with urethritis. Diagnosis: In diagnosis of gonorrhea a Swab of throat, vagina & rectum may collect bacteria that can be identify in a laboratory. Precautions advised: Abstain from sexual intercourse. Use of reliable condom every time of sexual intercourse. Have only one sexual partner who is uninfected and who is also sexually monogamous. Treatment: Antibiotics like ‘intravenous ciprofloxanin- 500 mg’; ‘intravenous ofloxacin-400 mg’; ‘intramuscular spectinomycin-2 gm’ are used.CONCLUSION In general,the studies reported similar low levels of knowledge and awareness of sexually transmitted diseases,with the exception of HIV/AID’s. Although ,as shown by some of the findings on condom use ,knowledge does not always translate into behaviour change, adolescents’ sex eduation is important for STD prevention, and the school setting plays an important role. Beyond HIV/AIDS, attention should be paid to infections such as Chlamydia,Gonorrhea and Syphilis.BIBLIOGRAPHY www.google.com www.wikipedia.com www.medindia.net www.mayoclinic.org www.slideshare.in Biology NCERT books of class 12