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Ø  it is a preventable cancer.

Ø  a known etiology, a hpv ( human papilloma virus)

Ø  a known mode of spread i.e sexually transmitted

Ø  a very good and inexpensive screening test called pap smear which identifies it several years ahead at a precancerous stage making it amenable to prevention and early treatment with good prognosis.

Ø  an effective vaccine

Ø  unlike other stis (sexually transmitted infections) it is not fully protected by condoms.

we live in an era of sexual liberalisation with far reaching consequences. stis are a rising concern, with long term consequences. hiv is just the tip of iceberg.

the high risk factors are those with

-        multiple sex partners

-        early initiation of sexual activity

-        poor knowledge of contraception

-        hesitation in using barrier method by male partners

-        low socio-economic status with poor access to health care services, including pap tests

-        prostitutes, prison inmates,  drug addicts, those attending sti clinics

-        smoking, low immunity status like hiv, use of birth control pills for > 5 years, being younger than 17 at the time of first delivery, multiparity i.e having 3 or more children.

even the first wife dying of a cervical cancer placed the second wife at high risk.

yet despite the familiarity with the disease, it continues to flourish especially in developing countries. most of those who suffered rarely made to the hospital in time. educated women, even doctors hardly turned up for their pap smear in time. may be it was a feminine trait, being indifferent to their own health.

an effective vaccine lay underutilised because of unawareness and sometimes non affordability.

a  report published by the centers for disease control and prevention (cdc) tells,

       young people aged 15-24 years develop half of all new sexually transmitted infections (stis),

       1 in 4 sexually active adolescent females has an sti

no wonder the lower limit of giving hpv vaccine, that acts best when given before the sexual debut has been brought down to 9 years of age; a definite sign of society’s paradigm

“this epidemic is one result of a sexually saturated culture and the myth perpetuated by academe, medicine and pharmaceutical companies that latex, contraception and  vaccines can make all sexual behavior risk free.” 

even among prime-time network television shows, there is only 1 portrayal of protective behavior or comment regarding stis for every 25 instances of sexual behavior shown.

sadly one-quarter of adolescents and young adults in high-risk age groups for stis did not have health care coverage.

only 11 percent of teenagers surveyed reported getting most of their information regarding stis from their parents or other family members.

knowledge and awareness of stis among the public is poor; almost two-thirds of women,18-60 years of age surveyed knew nothing or very little about stis other than aids.

young women and female adolescents are more susceptible to stis compared to their male counterparts because of their biological characteristics. during puberty and young adulthood, specific cells (columnar epithelium) are especially sensitive to invasion by certain sexually transmitted organisms are more exposed.

women and female adolescents may also find it more difficult than men to implement protective behaviors, partly because of the power imbalance between men and women

the only way to curb the rising epidemic was by :

  • inculcating responsible behaviour

sounds like a cliché but if you don’t take a detailed sexual history of your partner on your date, you don’t know him well enough to have sex.

and ‘safe sex’ is sex with your faithful spouse!  

  • encourage use of contraception ( barrier method )

§  enforcing pap smear in sexually active women ( 21-65 years) at least every 3 year( even in those previously vaccinated with hpv vaccine), or combining it with hpv testing every 5 years ( >30 years of age).

“screen-and-treat” and “screen, diagnose and treat” are both valuable approaches

 

  • promoting cervical cancer vaccine; may be a government initiative making the vaccine cost effective, mandatory or even free to all adolescent girls.
  • health education
  • tracing contact/ partner & treatment  for stis , wherever possiblecancer cervix is the leading cancer in indian women and the second most common worldwide. the precancerous changes start early, usually in the twenties, once the women is sexually active and if undetected and untreated  may turn into a full blown cancer by the time the woman is in her 50s.

    ironically, there are several good things about this cancer.

    Ø  it is a preventable cancer.

    Ø  a known etiology, a hpv ( human papilloma virus)

    Ø  a known mode of spread i.e sexually transmitted

    Ø  a very good and inexpensive screening test called pap smear which identifies it several years ahead at a precancerous stage making it amenable to prevention and early treatment with good prognosis.

    Ø  an effective vaccine

    Ø  unlike other stis (sexually transmitted infections) it is not fully protected by condoms.

    we live in an era of sexual liberalisation with far reaching consequences. stis are a rising concern, with long term consequences. hiv is just the tip of iceberg.

    the high risk factors are those with

    -        multiple sex partners

    -        early initiation of sexual activity

    -        poor knowledge of contraception

    -        hesitation in using barrier method by male partners

    -        low socio-economic status with poor access to health care services, including pap tests

    -        prostitutes, prison inmates,  drug addicts, those attending sti clinics

    -        smoking, low immunity status like hiv, use of birth control pills for > 5 years, being younger than 17 at the time of first delivery, multiparity i.e having 3 or more children.

    even the first wife dying of a cervical cancer placed the second wife at high risk.

    yet despite the familiarity with the disease, it continues to flourish especially in developing countries. most of those who suffered rarely made to the hospital in time. educated women, even doctors hardly turned up for their pap smear in time. may be it was a feminine trait, being indifferent to their own health.

    an effective vaccine lay underutilised because of unawareness and sometimes non affordability.

    a  report published by the centers for disease control and prevention (cdc) tells,

           young people aged 15-24 years develop half of all new sexually transmitted infections (stis),

           1 in 4 sexually active adolescent females has an sti

    no wonder the lower limit of giving hpv vaccine, that acts best when given before the sexual debut has been brought down to 9 years of age; a definite sign of society’s paradigm

    “this epidemic is one result of a sexually saturated culture and the myth perpetuated by academe, medicine and pharmaceutical companies that latex, contraception and  vaccines can make all sexual behavior risk free.” 

    even among prime-time network television shows, there is only 1 portrayal of protective behavior or comment regarding stis for every 25 instances of sexual behavior shown.

    sadly one-quarter of adolescents and young adults in high-risk age groups for stis did not have health care coverage.

    only 11 percent of teenagers surveyed reported getting most of their information regarding stis from their parents or other family members.

    knowledge and awareness of stis among the public is poor; almost two-thirds of women,18-60 years of age surveyed knew nothing or very little about stis other than aids.

    young women and female adolescents are more susceptible to stis compared to their male counterparts because of their biological characteristics. during puberty and young adulthood, specific cells (columnar epithelium) are especially sensitive to invasion by certain sexually transmitted organisms are more exposed.

    women and female adolescents may also find it more difficult than men to implement protective behaviors, partly because of the power imbalance between men and women

    the only way to curb the rising epidemic was by :

    • inculcating responsible behaviour

    sounds like a cliché but if you don’t take a detailed sexual history of your partner on your date, you don’t know him well enough to have sex.

    and ‘safe sex’ is sex with your faithful spouse!  

    • encourage use of contraception ( barrier method )

    §  enforcing pap smear in sexually active women ( 21-65 years) at least every 3 year( even in those previously vaccinated with hpv vaccine), or combining it with hpv testing every 5 years ( >30 years of age).

    “screen-and-treat” and “screen, diagnose and treat” are both valuable approaches

     

    • promoting cervical cancer vaccine; may be a government initiative making the vaccine cost effective, mandatory or even free to all adolescent girls.
    • health education
    • tracing contact/ partner & treatment  for stis , wherever possible
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    You can try a number of things to make yourself or your child more comfortable during a fever:

    • Drink plenty of fluids. Fever can cause fluid loss and dehydration, so drink water, juices or broth. For a child under age 1, use an oral rehydration solution such as Pedialyte. These solutions contain water and salts proportioned to replenish fluids and electrolytes. Pedialyte ice pops also are available.
    • Rest. You need rest to recover, and activity can raise your body temperature.
    • Stay cool. Dress in light clothing, keep the room temperature cool and sleep with only a sheet or light blanket.

      Taking a temperature

      To check your or your child's temperature, you can choose from several types of thermometers, including oral, rectal, ear (tympanic) and forehead (temporal artery) thermometers.

      Although it's not the most accurate way to take a temperature, you can use an oral thermometer for an armpit (axillary) reading:

    • Place the thermometer in the armpit and cross your arms or your child's arms over the chest.
    • Wait four to five minutes. The axillary temperature is slightly lower than an oral temperature.
    • If you call your doctor, report the actual number on the thermometer and where on the body you took the temperature.
    • Use a rectal thermometer for infants:

    • Place a dab of petroleum jelly on the bulb.
    • Lay your baby on his or her tummy.
    • Carefully insert the bulb 1/2 to 1 inch into your baby's rectum.
    • Hold the bulb and your baby still for three minutes.
    • Don't let go of the thermometer while it's inside your baby. If your baby squirms, the thermometer could go deeper and cause an injury.

      Over-the-counter medications

      In the case of a high fever, your doctor may recommend an over-the-counter medication, such as:

    • Acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others). Use these medications according to the label instructions or as recommended by your doctor. Be careful to avoid taking too much. High doses or long-term use of acetaminophen may cause liver or kidney damage, and acute overdoses can be fatal. If your child's fever remains high after a dose, don't give more medication; call your doctor instead. For temperatures below 102 F (38.9 C), don't use fever-lowering drugs unless advised by your doctor.
    • Aspirin, for adults only. Don't give aspirin to children, because it may trigger a rare, but potentially fatal, disorder known as Reye's syndrome.
    • You have a fever when your temperature rises above its normal range. What's normal for you may be a little higher or lower than the average normal temperature of 98.6 F (37 C).

      Prevention

      You may be able to prevent fevers by reducing exposure to infectious diseases. Here are some tips that can help:

    • Wash your hands often and teach your children to do the same, especially before eating, after using the toilet, after spending time in a crowd or around someone who's sick, after petting animals, and during travel on public transportation.
    • Show your children how to wash their hands thoroughly,covering both the front and back of each hand with soap and rinsing completely under running water.
    • Carry moist towelettes or hand sanitizer with you for times when you don't have access to soap and water.
    • Try to avoid touching your nose, mouth or eyes, as these are the main ways that viruses and bacteria can enter your body and cause infection.
    • Cover your mouth when you cough and your nose when you sneeze, and teach your children to do likewise. Whenever possible, turn away from others when coughing or sneezing to avoid passing germs along to them.
    • Avoid sharing cups, water bottles and utensils with your child or children.
    • When to see a doctor

      Fevers by themselves may not be a cause for alarm — or a reason to call a doctor. Yet there are some circumstances when you should seek medical advice for your baby, your child or yourself.

      Infants

      An unexplained fever is greater cause for concern in infants and in children than in adults. Call your baby's doctor if your child is:

    • Younger than age 3 months and has a rectal temperature of 100.4 F (38 C) or higher.
    • Between ages 3 to 6 months and has a temperature up to 102 F (38.9 C) and seems unusually irritable, lethargic or uncomfortable or has a temperature higher than 102 F (38.9 C).
    • Between ages 6 to 24 months and has a temperature higher than 102 F (38.9 C) that lasts longer than one day but shows no other symptoms. If your child also has other signs and symptoms, such as a cold, cough or diarrhea, you might call your child's doctor sooner based on severity.
    • A newborn and has a lower than normal temperature — less than 97 F (36.1 C). Very young babies may not regulate body temperature well when they're ill and may become cold rather than hot.
    • When in doubt, go ahead and call your child's doctor, whether you think your baby's temperature is abnormally high or abnormally low.

      Children

      There's probably no cause for alarm if your child has a fever but is responsive — making eye contact with you and responding to your facial expressions and to your voice — and is drinking fluids and playing.

      Call your child's doctor if your child:

    • Is listless or irritable, vomits repeatedly, has a severe headache or stomachache, or has any other symptoms causing significant discomfort.
    • Has a fever after being left in a hot car. Seek medical care immediately.
    • Has a fever that lasts longer than three days (in children age 2 and older).
    • Appears listless and has poor eye contact with you.
    • Ask your child's doctor for guidance in special circumstances, such as a child with immune system problems or with a pre-existing illness. Your child's doctor may also recommend precautions if your child has just started taking a new prescription medicine.

      Adults

      Call your doctor if your temperature is 103 F (39.4 C) or higher, or if you've had a fever for more than three days.

      In addition, seek immediate medical attention if any of these signs or symptoms accompanies a fever:

    • Severe headache
    • Severe throat swelling
    • Unusual skin rash, especially if the rash rapidly worsens
    • Unusual sensitivity to bright light
    • Stiff neck and pain when you bend your head forward
    • Mental confusion
    • Persistent vomiting
    • Difficulty breathing or chest pain
    • Extreme listlessness or irritability
    • Abdominal pain or pain when urinating
    • Muscle weakness or sensory changes, which might indicate a problem with your nerves, spinal cord or brain function (focal neurologic deficit)
    • Seizure
    • Any other unexplained signs or symptoms

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