Posted by admin on March 12, 2009 under Men's Health-Erectile Dysfunction | 
Prevention of infection in health care establishments
Health care establishments including medical practitioners’ rooms should establish appropriate infection control guidelines to prevent exposure of staff to blood and body fluids. Detailed Infection control guidelines have been published by the AIDS Task Force. Staff at risk of hepatitis В should be immunised.
Management of exposure
Hepatitis В immunoglobulin (HBIG) is effective in protecting a person exposed to infection e.g. the sexual contact of a carrier or a person exposed to infection by a needlestick injury. HBI should be given soon after exposure (within 72 hours of a needlestick). Such a patient should be immunised.
Management of infants of hepatitis В carrier mothers Antenatal testing for HB There is a high risk of chronic infection in babies born to carrier mothers markers should be routine and me testing of pregnant women should be routine. The infants of carrier
mothers should be given immunoglobulin within hours of birth and
immunised. The infants of mothers who belong to high risk groups but
who are marker free should be immunised.
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The treatment of choice is erythromycin 500 mg every 6 hours for at least 7 days and continued until the lesions heal. Alternatively, trimethoprim and sulphamethoxazole (160/800 mg) twice daily for at least 7 days, or intramuscular ceftriaxone may be used.
Local therapy has an important role particularly in the treatment of subpreputial lesions. Lesions should be kept clean and dry by careful cleaning; the prepuce should be kept retracted until the lesions heal.
Early antibiotic treatment will usually abort the development of buboes. Inguinal buboes may be aspirated through normal skin to relieve pain but should not be incised. If buboes are incised or spontaneous eruption occurs, permanent scarring and deformity are likely.
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NGC may present as a vaginal discharge, as symptoms of urethritis or as low abdominal pain. Most women with NGC present as the symptom-free partners of men with NGU.
Speculum examination may reveal a cervical discharge with or without an inflamed cervix. The cervix may appear normal.
The most important complication of NGC is the spread to the upper genital tract to cause endometritis, salpingitis and PID.
Babies born to mothers infected with chlamydia are commonly infected and may present with conjunctivitis, pneumonitis or middle ear infections.
Reiter’s disease occasionally follows infection with С trachomatis.
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Introduction
Causative organisms
Urethral and cervical inflammation are common presentations of STD. The most common STDs manifested by urethritis or cervicitis are gonorrhoea caused by Neisseria gonorrhoeae and non-gonococcal urethritis (NGU), and non-gonococcal cervicitis (NGC) caused by Chlamydia trachomatis. Other causes of these presentations include the genital mycoplasmas, candidiasis, trichomoniasis and herpes simplex infection.
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In Western society most patients with STD are in the 15 to 30 year age group. There has been increased recognition of sexual abuse of children, and practitioners should be alert to the existence and significance of STD particularly in young children.
People with multiple sexual partners (including prostitutes) are at higher risk of STDs than are members of the general community. AIDS has had a considerable impact on the sexual behaviour of homosexual men among whom STDs had been common.
In Australia, the most important STDs are chlamydial infection, gonorrhoea, genital herpes, HIV infection, human papilloma virus infection, syphilis and hepatitis B. Penicillin resistant gonococcal infection is an increasing problem.
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Posted by admin on March 11, 2009 under Men's Health-Erectile Dysfunction |
You don’t give a woman an orgasm any more than she gives you an orgasm. But if you are a considerate lover you can help your partner create her own orgasm – if and when she wants you to. She may be one of the 40 per cent of women who reach orgasm during intercourse. If she is, she can tell you which movements of yours give her increased sexual feeling, and which damp her feelings down. If she is one of the 60 per cent of women who do not reach orgasm during intercourse, she can almost certainly have an orgasm if you help her by caressing her clitoral area with your finger or tongue, or if she masturbates. If she chooses to masturbate it is not an insult to your skill as a lover: it is what she wants. Some women enjoy masturbating to orgasm during sexual intercourse, others prefer to be helped to orgasm by finger or tongue before sexual intercourse, or after you have had your orgasm. Unfortunately, many women who are left sexually aroused, but frustrated, because they do not reach orgasm during intercourse are ashamed to masturbate (although they desperately want to have an orgasm) for fear of embarrassing or revolting their partner, or because of their own sexual inhibitions.
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Most men do not know if their sexual partner has a real or a faked orgasm unless they are sufficiently relaxed to be able to talk to each other about their sexuality. A man may agree that other men may not know, but that he knows when his partner comes. He may say that it is easy to tell: as he thrusts urgently with his penis in her vagina, she tightens her legs and pelvic muscles, she scratches his back or bites his lip, she moans ecstatically, she writhes about and arches her back. A few women do this when having an orgasm, but the majority do not moan, and certainly do not writhe about or arch their back. During orgasm, most women, at first, become still and rather rigid, with tense muscles as the intense, deep-felt pleasure of orgasm surges up from the pelvic area to envelop them. Only later in orgasm does movement occur, and then not always. One of Shere Hite’s respondents wrote, ‘I don’t move convulsively the way women in books do. I don’t know if anyone does. I just hold on tight. Sometimes it bothers me when a man hasn’t been able to tell that I climaxed.’
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The fourth phase, the resolution phase, is the period during which the individual’s response resolves from the climactic peak of orgasm, and returns rapidly to the unstimulated state. During the first few seconds of this phase the glans of the penis is extremely sensitive to touch, and the man is unable to respond to any sexual stimuli. This phase usually merges into a phase of contentment, of love, of relaxation, of warmth, of well-being, and usually of sleep. The old adage that the sleep of the just is not as good as the sleep of the just-after is all too true! This can cause sexual conflict if the man’s partner, having failed to obtain sexual release, finds at best a sleeping man holding her in his arms, and at worst, the inert, snoring mass of a satiated man lying beside her. Yet in fairness to the man, his pleasure in sexual intercourse may be reduced if he is unable to enjoy the short period of complete relaxation which characterizes the later part of the resolution phase. In fairness to the woman, it can be remarkably frustrating to be sexually stimulated but not helped to orgasm. The solution must be for the couple to talk to each other about the problem and reach a compromise. If the woman does not reach orgasm during sexual intercourse, the man can help her reach orgasm by stimulating her clitoris with his finger or his tongue either before he ejaculates or afterwards. The couple may decide to vary their technique from time to time, so that the man can enjoy the relaxation of the resolution phase more fully.
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If a man does not have sex frequently, in which he has orgasms and ejaculates regularly, his testicles will become swollen with unreleased sperms and will ache intolerably (in America this condition is called ‘blue balls’) This male-oriented myth is untrue on two counts. First, the sperms only form a small proportion of the semen, most of which is composed of secretions from the prostate gland. When sperms are formed and not ejaculated, sperm production slows down and no increased tension occurs in the testicles. Moreover, men who have had a vasectomy do not get painful testicles. Any pain a man feels in his testicles, if he does not ejaculate often, is due to psychological, not to physical, factors.
It is true that if a man is stimulated and stays in the plateau phase of sexual arousal for a long period of time vasocongestion of his testicles will occur, and their size can increase by as much as 75 per cent. In this situation the man may get testicular pain, which is relieved by orgasm. This is a normal sexual response and is not to be confused with the mythical ‘blue balls’ which is said to occur if a man does not have sex often.
The second count on which the myth is untrue is that if a man feels the psychosomatic testicular pain from insufficient sex, he can masturbate to orgasm. He does not need to have sexual intercourse.
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In spite of the high percentage of sexually active teenagers there was little evidence of promiscuity. Few of the teenagers were sexual adventurers. Christine Farrell comments, ‘The majority of young people currently involved in a sexual relationship were having sex with someone they had been going out with for more than six months, and there was no evidence that the pill was encouraging casual relationships.’ Most of the sexually active teenagers used some form of contraception, and only one in twelve did not. The form of birth control most commonly used was the condom, followed by withdrawal, and, increasingly, the pill.
In the U.S.A. Zelnik and Kantner’s 1976 survey followed the same pattern as their earlier study. They concentrated their efforts on seeing if changes had occurred in the sexual behaviour and contraceptive experience of teenage women. Their findings confirmed an increase in sexual activity by teenage unmarried women. They found that by the age of 19, 55 per cent of unmarried teenage women had had sexual intercourse compared with 47 per cent in the survey of 1971, an increase of 18 per cent. As well as this, they found that teenage women were having sex earlier, and there was a 30 per cent increase in the number of women aged 15 to 19
who had sexual intercourse. There had been a tendency, in the five-year interval, for a woman to have more sexual partners, although 51 per cent of the women had sexual intercourse with only one partner by the age of 19. Thirty per cent of women had had sex with two or three men, and 23 per cent were sexual adventurers, compared with 16 per cent in 1971.
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