Trichomoniasis is a common sexually transmitted disease that affects both women and men, although symptoms are more common in women. Trichomoniasis is a vaginal infection caused by a protozoan called T. vaginalis.

History of the patient may include:

  • New or multiple partners
  • History of STDs
  • Reports engaging in commercial sex work
  • Use of injection drugs
  • Partner symptoms of STDs
  • Sexual activity (last exposure, exposure sites)
  • Lack of STD protection
  • Report of dyspareunia

If there are signs, they usually come 4 to 20 days after contact with an infected partner, but the signs can come months or even years after infection.

 Symptoms:

  • Yellow-green vaginal discharge
  • Vulvar/vaginal pruritus, burning, irritation
  • Urinary frequency/dysuria
  • Postcoital spotting
  • Most men who are infected have no signs. Some men with trich have thin, clear, or white discharge from the penis, or pain while urinating.

Physical tests are performed to diagnose the infection. Inspection of the vulva, vagina, and cervix are done to assess for: Erythema, swelling, vaginal discharge, punctate cervical lesions (“strawberry patches”) , inflammation of Skene’s or Bartholin’s glands and urinary meatus, and urethral discharge for males. Laboratory testing for women include: Wet prep with pH, saline, KOH and Possible adjunct testing (e.g. OSOM Trichomonas Rapid Test).

The patient should follow the given guidelines:

  • Avoid alcohol during treatment
  • Abstain from sexual intercourse until therapy is completed
  • Information and awareness on Trichomonas as a sexually transmitted infection
  • Inform the sex partner about your infection
  • Know the contraceptive methods
  • Encourage Condom use consistently and correctly to prevent STDs

There is no lasting damage, but women with trichonomiasis may be more likely to have babies who are premature or too small.  For both men and women, trichonomiasis can cause inflammation of the genitals that makes it easier to get other sexually transmitted diseases.  Use a new condom every time you have sex.  Birth control pills do not prevent trichonomiasis or other sexually transmitted diseases. Being treated for trichonomiasis does not prevent you from becoming re-infected after unprotected sex.

Combination therapy for treating pleural infection

As per the research reports, the combination therapy with two drugs provides effective way for treating patients with pleural infection, a serious respiratory condition.

The severe cases of pneumonia or lung infections may lead to pleural infection marked by accumulation of infected fluid in the space present between ribs and lungs. This infected fluid exerts pressure on the lungs resulting in breathing problems.

The standard treatment regimen comprises of using antibiotics and draining the accumulated fluid by inserting the tube into the chest. However, this treatment approach is not effective in 33% of the cases and surgical option is not appropriate for older patients.

According to the results of clinical trial conducted by researchers at the University of Oxford; a one week treatment with combination therapy involving tissue plasminogen activator (tPA) and DNase produced the following results.

                    30 percent reduction in the amount of infected fluid in the chest compared to 17 percent with placebo

                    Reduction in fever

                    Reducing the need for surgery

                    Shortening the hospital stay

Dr. Najib Rahman remarked that although the individual drug does not yield any results, however combination therapy shows significant improvement in drainage of the infected fluid. This study has been published in New England Journal of Medicine (Aug 11 issue).

Although the therapy may appear costly ($1,600), however it can offset the expenses by savings from shorter hospital stays. According to the researchers, the combination therapy is recommended for patients who are not fit for surgery or haven’t responded to standard treatments.

Pain killers raise Pnuemonia risk in elderly

The opioids raises the risk of pneumonia in elderly patients aged 65 to 94. This was found in the study conducted by researchers at University of Washington and Group Health Research Institute.

Opioids belong to a class of painkiller medicines while benzodiazepines are given for treating insomnia and anxiety. According to the study leader, Sascha Dublin; some opioids might contributes to the pneumonia by harming the immune system.

The results of the research conducted by Dr Dublin and her research team state that there is high risk of pneumonia in people using opioids or benzodiazepines as compared to people not using these medications. Moreover, those opioids that suppress the immune system present highest risk.

Guidelines for Treating Pneumonia in Children

The new guidelines for treating children from life-threatening pneumonia are suggested by Pediatric Infectious Diseases Society (PIDS) and the Infectious Diseases Society of America (IDSA).

As per new CDC guidelines, the prevention of bacterial pneumonia is considered as top priority in diagnosis and treatment of community-acquired pneumonia (CAP) in infants and children.

The major infectious agent of pneumonia in infants and preschool children is virus and that needs to be treated by using anti-virals rather than antibiotics.  However, in case of bacterial pneumonia (most serious type), the antibiotics are mandatory.

The new guidelines from PIDS and IDSA offer all the doctors around the world, a roadmap to the diagnosis and treatment of pneumonia in children.