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Sexually Transmitted Diseases (STDs) affect millions of people each year. The most common STDs are gonorrhea, chlamydia and trichomoniasis. While even thinking about STDs and whether you may have one is scary, knowing the facts can make a big difference in your long-term health. Here is what you need to know:

People who are sexually active with multiple partners and are not using barrier protection are at most risk. Teenagers are a large part of this group, because they dont always practice safe sex and they are more likely to have multiple partners. It is recommended that women who are sexually active with multiple partners get screened yearly or immediately after they have engaged in unprotected sex. If you discover that you have an STD, both you and your partner would most likely be treated with antibiotics.

Gonorrhea
Approximately 350,000 cases of gonorrhea were reported to the CDC in 2006, but because not everyone is getting tested for STDs, experts believe the actual numbers are twice that.

The symptoms for gonorrhea are burning with urination, abnormal discharge or pelvic pain. Pelvic pain indicates a very severe infection. Untreated gonorrhea can lead to a serious infection as the disease may spread to a womans fallopian tubes and cause infertility.

Chlamydia
There were 1,000,000 cases of chlamydia reported to the CDC in 2006; experts think the actual rate of infection is as high as 2,000,000 cases.

Chlamydia is often called the silent disease because many people with chlamydia have no symptoms. Chlamydia can affect the urethra, the vagina, the cervix and the fallopian tubes. Symptoms include burring with urination, abnormal discharge and pelvic pain. If you are experiencing any of these systems you should see your doctor to determine if you have chlamydia. Women with chlamydia who arent treated are likely to develop pelvic inflammatory disease. Pelvic inflammatory disease occurs when the infection spreads and causes scarring to the uterus and fallopian tubes. Untreated chlamydia can result in infertility.

Trichomoniasis
Trichomoniasis is the most common STD. About 7 million women and men have trichomoniasis. Women who have trichomoniasis will often experience a frothy yellow or green discharge coming from their vagina. But some people wont have any symptoms.

Understanding STDs, what causes them, and how to treat them will help you stay in control of your health.

The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.

The is a time lapse video animation of a complicated ear infection with a ruptured eardrum causing drainage with eventual healing. The video also shows why a period of hearing loss and clogged/muffled ear sensation may occur.

Identify the anatomy and explain the physiology of the scrotum on diagrams and sonograms.

Describe and demonstrate the protocol for sonographic scanning of the scrotum.

Identify and describe sonographic images of congenital abnormalities of the scrotum.

Identify and describe sonographic images of pathologies of the scrotum.

Identify and describe sonographic images of extratesticular disease processes.

Identify the anatomy and explain the physiology of the prostate on diagrams and sonograms.

Describe and demonstrate the protocol for transabdominal and endorectal sonographic scanning of the prostate.

Identify and describe sonographic images of benign and malignant pathologies of the prostate, including benign hyperplasia, prostatitis, carcinoma, and calculi.

Explain the technique for prostate biopsy.

Define the criteria for an ultrasound appearance of prostate tumor staging.

Explain the technique for radiation seed implantation.

Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference).

Surgical abortion using the dilatation and curretage technique.

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Systemic lupus erythematous is an autoimmune condition characterised by damage to organ systems due to autoantibodies and immune complex deposition. Genes, epigenetic changes and environment play a role in its pathogenesis. SLE is a truly multi system disease causing widespread clinical manifestations in almost all organ systems. Autoantibodies in SLE are numerous and mainly include ANA, dsDNA, Sm and others.

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This condition is seen in imperforate hymen or transverse vaginal septum. Pt presents with primary amenorrhea. Dr Hemant Damle Prof Dept of OBGYN SKNMC Pune India