Reproductive Tract Infections (RTI): Symptoms and Causes

Reproductive piece of land Infections (RTI) Symptoms and CausesReproductive piece of reason fittingness infections (RTI) argon recognise as a public health problem and ranking second after maternal morbidity and mortality as the cause of loss of estimable life among women of fruitful age in developing countries (Jindal et al, 2009.). Infections of the procreative folder causes unspoilt health problem worldwide, with an impact on individual women and men, their families and communities (Adler et al., 1998). Are RTI infections which come across the reproductive tract, part of the reproductive system. For females, the reproductive tract infections may be much high ge atomic number 18r in the reproductive tract (fallopian tubes, ovaries and uterus) and lower reproductive tract (vagina, neck opening and vulva). The global burden of reproductive tract infections (RTI) is a huge and a serious public health problem, oddly in developing countries, where ITR ar endemic .They r egress out wee-wee serious consequences including infertility, ectopic pregnancy, chronic pelvic pain, abortion, cervical cancer, menstrual illnesss, pregnancy loss, babies with low birth weight and increased endangerment of HIV transmission. The presence of the ITR (especially ulcer causing sexually transmitted infections) can promote the acquisition and transmission of gentle immunodeficiency virus (Rabiu et al., 2010). Reproductive tract infections take endogenous infections, iatrogenic infections and sexually transmittedinfections (STDs) (Muula et al., 2006) .Reproductive tract infections (RTI) refers to three different types of infections affecting the reproductive tract 1. Endogenous infections are probably the closely usual RTI worldwide. They result from an overgrowth of organisms normally present in the vagina. Endogenous infections include candidiasis and bacterial vaginosis. These infections can be easily treated and cured .2. induced infections occur when the c ause of infection (bacteria or another(prenominal) microorganism) is introduced into the reproductive tract via a checkup procedure, such as menstrual regulation, abortion, insertion of an IUD or during peasantbirth. This can happen if the surgical instruments used during the procedure has not been properly sterilized, or an infection, which was already present in the lower reproductive tract is pushed by mode of the cervix into the upper reproductive tract .3. Sexually transmitted diseases (STDs) are caused by viruses, bacteria or parasites microorganisms that are transmitted through sexual action mechanism with an infected partner. About 30 different sexually transmitted infections have been identified, some of which are easily treatable, some(prenominal) of which are not. HIV, the virus that causes AIDS, is perhaps the most serious sexually transmitted infection, since it eventually leads to death. STDs affect men and women, and can excessively be transmitted from mother to child during pregnancy and childbirth. (Germain et al. 1992).Female RTI unremarkably originate in the lower genital tract, such as vaginitis or cervicitis and can produce symptoms such as abnormal vaginal discharge ,genital painitchingburning feeling with urinationabdominal painirregular mensural cycleblood stained dischargeHowever, a high prevalence of asymptomatic disease occurs, which is a barrier to hard-hitting control (Elias et al., 1993). Such asInfertilityFibroidPolypsProlaps Uterus / VaginalEndomitrosisEven when symptoms occur, their presence may overlap with and be misdiagnosed as a normal physiological change and normal physiological discharge can be diagnosed as RTI. (Trollope Kumar, 1999). The presence of ulcers, especially RTI causing STI may increase the acquisition and transmission of human immunodeficiency virus (Fleming et al. 1999).Infertility is a health problem in Africa, tokenly in sub-Saharan Africa, where 20-30 % of couples are unable to conceive (Scia rrha, 1994). Most health advocates consider infertility as the most authoritative reproductive health and social issues confronting the Nigerian women and gynecologists lucks report that infertility is 60 % 70 % of your queries at higher education institutions (Okonofua et al, 1997.). In Nigeria, most crusades of infertility RTI following (Snow et al. 1997)ectopic pregnancy is a life-size percentage of acute gynecological emergencies in Nigeria and is a major cause of maternal mortality 11-13 . A study in Lagos, Nigeria found previous STI and pelvic inflammatory disease as the main risk factors for ectopic pregnancy (Anorlu et al., 2005)Cervical cancer is usually the result of a sexually transmitted infection, and human papilloma virus is the causative agent. It is the most common malignancy of the reproductive system and a leading cause of death from cancer in Nigerian women (Thomas, 2000). In contrast to most other types of cancer, it is common below the age of 50, and is t herefore a leading cause of premature death (Dey et al. 1996).Sites of Reproductive Tract Infections Reproductive tract infections can affect the outer genitals and reproductive organs. Infections in the area of the vulva, vagina, cervix or are referred to as the lower reproductive tract infections. Infections in the uterus, fallopian tubes and ovaries are considered upper reproductive tract infections. (Bulut et al. 1995)Minor infections of the reproductive tract . Vaginitis RTI affecting the external genital area and lower reproductive tract in women is very much referred to as vulvo vaginitis, vaginitis or simply indicating that the vulva and / or vagina suit inflamed and somemagazines itchy or painful. Vaginitis is most comm plainly caused by endogenous infections such as candida (thrush, yeast) or bacterial vaginosis, sexually transmitted infections despite certain as trichomoniasis, can withal commonly cause these symptoms and signs. pelvic infections can have consequences far much dangerous than the initial vaginitis, such as ectopic pregnancy or infertility. (Bulut et al. 1995)2. Infection of the cervixInfection of the cervix can be caused by a variety of pathogens, particularly sexually transmitted infections, such as gonorrhea, chlamydia and Human Papillomavirus transmitted. Infections of the cervix are considered more serious than vaginitis because more commonly result in infection of the upper reproductive tract, with its serious consequences. Unfortunately, they are also more difficult to detect and are often asymptomatic. (Bulut et al. 1995)Upper Reproductive Tract Infections The migration of infection in the upper reproductive tract, including the uterus, fallopian tubes, ovaries, and tends to be more severe than infections of the lower reproductive tract. Infections of the upper reproductive tract are often a direct complication of infections, especially sexually transmitted lower reproductive tract. (Bulut et al. 1995)Pelvic inflammatory disease (PID), for example, is one of the most serious problems of gonorrhea or chlamydia. This can result in chronic abdominal pain, ectopic pregnancy, menstrual irregularities, infertility and as a result of scarring of the fallopian tubes .Ectopic pregnancy, which can cause death, is a particularly serious complication, since it requires emergency interventions that are not available in many resource-poor settings.Iatrogenic infections -. Caused by the introduction of bacteria in normally sterile environment of the womb through a medical procedure such as insertion of an IUD can also result in serious, and reproductive tract infections, occasionally life -threatening upper (Bulut et al .., 1995) minimal brain damage in Classroom Strategies Literature Review attention deficit hyperactivity disorder in Classroom Strategies Literature ReviewTo what extent can teachers make provisions for pupils with minimal brain damage ( guardianship-Deficit HyperactivityDisorder) in the mainstre am frameroom?CONTENTS (JUMP TO) contribution 1 Referenced ExtractsSection 2a Part One Analysis and Critical Evaluation of the IssueSection 2b Part Two Examination of the Practical Implications for Primary rail TeachersSection 3 Copies of ExtractsSection 4 Bibliography Sources and Further ReadingSection 1 Referenced Extracts(1) Quarmby, K. (Tuesday 6 December, 2004) Rebels without a Cause Children with Behaviour Problem are Increasingly Diagnosed with attention deficit hyperactivity disorder, in, didactics Guardian, pp.1-3(2) The Disorder named AD/HD What we know (2004) National Resource Centre for AD/HD Children and Adults with Attention-Deficit HyperactivityDisorder (CHADD http//www.help4hyperkinetic syndrome.org/en/about/what/WWK1.pdf , p.2(3) Rafolovich, A. (2005), Exploring Clinician Uncertainty in the Diagnosis and Treatment of Attention-Deficit Hyperactivity-Disorder, in, ledger of Sociology of Health and Illness, Volume 27, Number 3 London Blackwell, pp.306310(4) Nor hen ce, S. (Friday 26 November, 2004), Feed your Head, in, The Times Educational Supplement, p.3(5) Spencer, T. et al (1995), A Double-Blind CrossOver Comparison of methylphenidate and Placebo in Adults with Childhood Onset Attention-Deficit Hyperactivity-Disorder, in, Archives of General Psychiatry, Volume 52, pp.434-443(6) Education Guardian Opinion (Tuesday 10 October, 2006), p.4(7) Handy, C. and Aitken, R. (1986) Understanding Schools as Organisations London Penguin, p.13(8) Chowdhury, U. (2004) Tics and Tourettes Syndrome a Handbook for Parents and Professionals London and New York Jessica Kingsley, p.115(9) Raphael Reed, L. (1995) Reconceptualisng Equal Opportunities, in, Griffiths, M. and Troyna, B. (Eds.), Antiracism, Culture and Social Justice in Education StokeonTrent Trentham, p.88(10) Guiding Principles for the Diagnosis and Treatment of AttentionDeficit HyperactivityDisorder (2006), Presented by the Attention Deficit Disorder Association (ADDA) http//www.add.org/pdf/Guiding Principles021206Rev1.pdf , p.2(11) Jones, A. (August 2004) Clinical Psychology Publishes Critique of minimal brain dysfunction Diagnosis and Use of Medication on Children, in, Psychminded Website http//www.psychminded.co.uk/news/news2004/august2004/Clinicalpsycholgy(12) Swanson, J.M. and Cas recogniseanos, F.X. (2002) Biological Bases of ADHD Neuroanatomy, Genetics and Pathophysiology, in, Jensen, P.D. and Cooper, J.R. (Eds.), Attention Deficit Hyperactivity Disorder State of the Science Kingston New Jersey, pp.71-72(13) ADHD Strategies for Primary School Teachers http//premium.netdoktor.com/uk/adhd/living/school/article.jsp?articleIdent=uk.adhd.living.school.uk_adhd_xmlarticle_004691(14) ADHD in the Classroom What Helps http//www.adhd.com/educators/educator_communication_difficulties.jsp(15) Selikowitz, M. (2004) ADHD the Facts Oxford Oxford University Press, p.154(16) Stein, D.B. (1999) Ritalin is not the Answer a Drug-Free, Practical Programme for Children Diagnosed with ADD o r ADHD New York Jossey Bass Wiley, PrefaceSection 2a Part One Analysis and Critical Evaluation of the IssueThe issue of ADHD is one of the most wardrobe contemporary concerns within the broader educational sphere of making adequate provisions for children with learning difficulties. With the help of scientists and the media, ADHD has been transformed from a relatively unknown malady of the brain to a well known national problem for thousands of schoolchildren. The increase in awareness has been accompanied by a steep procession in the number of children being diagnosed with the disease. The National Institute for Clinical Excellence (NICE) estimates that as many as 500000 children in the UK may have ADHD and, of these, as many as 100000 may be seriously affected.(1) Unbelievably, this figure amounts to approximately one in twenty of all British schoolchildren. With figures constantly on the rise and awareness increasing in tandem, it is clear that ADHD is, at the beginning of the twenty gloweringshoot century, a exceedingly important concern for any mainstream indigenous election school teacher.In comparison to other behavioural problems experienced by young people, the unsoundness is relatively new (at least in terms of its learning from psychiatrists and general practitioners) and, as such, often causes confusion and misunderstanding when the issue is raised in the classroom. Tourettes syndrome, for example, has a ten year advantage over ADHD in terms of public awareness and forthright medical opinion. Moreover, the illness is also notoriously difficult to accurately quantify with rather ambiguous symptoms desire inattentiveness and a lack of concentration used as precursors to a diagnosis of attentiondeficit hyperactivitydisorder. ADHD is consequently considered to be a exceedingly controversial illness that has the medical community split over whether it is a disability in the traditional sense or whether it is a neurologic break on the part of the child or individual in question. This is not an easy problem to solve not least because of the scarcity of medical facts.Indeed, the medical facts that are known are somewhat ambiguous and rely heavily on subjectivity rather than objectivity, which would bequeath an improved perspective for scientists and teachers alike. It has, however, been concluded that the illness begins no later than the age of 7 and patients who are first diagnosed as ADHD sufferers in adulthood moldiness have displayed the core symptoms from the age of seven to receive treatment for attentiondeficit hyperactivitydisorder this places the issue directly within the realm of the aboriginal (as opposed to the secondary) school teacher as the first tell-tale signs must be evident before the age of seven (year three).It is therefore prudent to detail these core symptoms of the disease so that the primary school teacher may be in a position to offer better advice to parents and doctors as to the condition to one of their pupils. For this, analysis must turn towards the USA, which is the leading terra firma in terms of diagnosing, treating and including children with the illness in national classrooms. Thus, tally to the American National Resource Centre for AD/HD, symptoms can be split into both separate categories (2). The first category comes under the heading of inattention. The chief features of this areMaking careless mistakes in homework, in class and in other related activities. Failing to pay close attention.Difficulty maintaining attention during work or play.Appearing as if not listening when clearly being mouth to.Failing to follow simple instructions in class.Have difficulties with organisation.Avoiding work with a sustained amount of mental excursion, such as homework or tests.Loses things.Easily distracted.Forgetful in daily activities.The second category used for ascertaining the most visible symptoms of ADHD comes under the heading of hyperactivity-impulsive beha viour. The core features of this particular behavioural manifestation areConstant fidgeting in class with hands or feet. Squirming in chairs.Running or climbing at inappropriate times.Has impediment remaining seated.Difficulties in maintaining silence during quiet play times.Failing to wait for turn in class.Interrupting teachers and fellow pupils at inappropriate times.Act as if they are on a motor.It is immediately evident from just a brief overview of the symptoms that ADHD is open to a wide variety of claims of intrueness with regards to diagnosis as well as excessive interference on the part of parents, teachers and the state, which has made the cause of children with learning difficulties a chief domestic policy since the end of the twentieth century. Sceptics naturally point to the many years before ADHD became a well known disorder (during the 1980s) as evidence that the illness has been winded out of proportion (help groups, on the other hand, say this is merely evidence of the bearing in which the illness has been avoided by education professionals for so long.)Furthermore, according to an a posteriori study compiled by Adam Rafolovich (3), even doctors retain strong reservations about diagnosing a child with ADHD on the grounds of the fertile ground for misconception that exists with concerns to the symptoms highlighted above. For instance, there can be little doubt that there is a very fine line between defining a child as clinically inattentive and simply viewing that same child as lazy and disinterested in the subject matter at hand. Likewise, the same problem persists with any variety of the core symptoms of ADHD, which are often too close to everyday behavioural disorders that should be expected in children as young as seven or eight. Once again, it is not difficult to understand the sceptics point of view, especially when considering that the modern variation of schooling is a lot more pupil friendly than was the case forty or fifty years ago.Psychiatric experts and doctors are likewise divided over the scoop up means of treatment available to children who have been satisfactorily diagnosed with ADHD. In the 1990s, medication was seen as by far the most viable route to inclusion in the classroom with the wonder drugs Ritalin and Concerta witnessing an explosion in sales at this time. Prescriptions for these two drugs have leapt from 6000 in 1994 to around 345000 by 2003. This marked increase is testimony to the way in which ADHD has become a serious problem for all mainstream teachers, particularly those who work in primary schools. In addition, there have been enter concerns voiced by doctors, parents and teachers regarding the moral aspect of prescribing a child as young as five or six a powerful, sophisticated neurological drug that alters the way the brain perceives key data. Young peoples brains do not fully develop until well into adolescence and often beyond thus, the risks in having children become dependen t on medication at such a young age should be obvious to all concerned. Moreover, as Stephanie Northen (4) points out, the fact that ADHD is seen as a biochemical imbalance in the brain requiring a pharmaceutical treatment while, at the same time, dyslexia is seen as a solely educational problem that has no connection with the brain, severely tests the rationale behind the way that the illness is currently being classified and treated. In many cases the difference between the two is only the opinion of a teacher, doctor or mental health observer.On the whole, however, medication has proved to be a success in young children with ADHD at least in terms of lessening the tendency for public outbursts and school time tantrums. Research conducted by the MTA Co artisan Group at the end of the twentieth century discovered that approximately 70 to 80% of school children with ADHD reacted positively to psycho stimulant medications. momentous academic improvement has likewise been noted with an increase in attentiveness in the classroom, compliance on group related tasks and a greater accuracy evident in homework, coupled with a decrease in activity levels, impulsivity, negative social behaviours in groups and verbal hostility (5). The implications of medication and the effects that this can have on a child who displays the key symptoms of inattention, impulsivity and hyperactivity will be discussed in greater detail in Part Two of the discussion, but, at this point, the important point to note is the relatively high level of success of prescription drugs in the effort to minimise the negativeThe other major option with regards to effective treatment is the option of psychotherapy involving a mental health expert and groups of child sufferers of ADHD. Utilising a form of cognitive behaviour therapy, qualified experts are able over time to challenge the way in which children react to certain environments and situations those situations that had previously led to evide nce of what are considered to be the core symptoms. ADHD coaches also help the child to prioritise, organise and develop interactive skills that will lessen the chances of that child experiencing a sense of social exclusion. There are also a number of problems with this kind of therapy not least the obstacle concerning the considerable costs incurred via employing a mental health professional in the current NHS climate. Theory and coiffe therefore still stand some way apart when it comes to the ideal means of treating children with ADHD faced with the reality of NHS staff shortages and a scarcity of personal sector mental health experts who concentrate solely on children with learning difficulties.There is also the probatory problem of stigmatisation when a child is diagnosed and then treated for ADHD or, indeed, any other mental health problem. To understand the severity of the issue, one need only look at the way that the adult labour force in the UK discriminates against emplo yees who have a mental health issue in order to understand the way in which vacation spots can become a source of intensive bullying, especially below the age of eight according to the Guardian Education Opinion in October 2006 (6). When one considers the fact that schools are, according to Charles Handy and Robert Aitken (7), not at all dissimilar to adult commercial organisations, it becomes even more clear that bullying and peer pressure are significant issues when it comes to schooling children with learning difficulties and behavioural problems, which ADHD obviously entails. As Uttom Chowdhury declares, the more a child stands out as different from his or her classmates because of associated behaviours such as impulsivity, poor handwriting and academic difficulties (8) the greater the likelihood of bullying and social exclusion. Primary school teachers would have a pivotal role to play in the cessation of bullying on the grounds of a mental illness, in addition to maintaining an effective social balance within the classroom. Furthermore, a pupil who suffers from ADHD is bound to display signs of low self gaze, regardless of bullying in the playground or peer pressure within the classroom. Low self esteem combined with the unpredictable side effects of the medication as well as mitigating factors that may be occurring at home, means that the task of a mainstream primary school teacher is made all the more time consuming.It can be seen that attentiondeficit hyperactivitydisorder is not only a highly topical issue that is bound to increase in significance in the coming decades, but that it is also a highly problematic area of upset for public education and child welfare due to the ambiguity that resides at the heart of the diagnosis of the condition. While there are a number of telltale signs that a child may be suffering from ADHD there are also any number of alternative reasons as to why a student appears to be veering away from the carefully construct ed consensus of a primary school classroom. Ultimately, some children would just prefer not to be in school at all. With this in mind, it is prudent to turn attention towards the implications for teachers who wish to advance the governmental policy of social inclusion in the classroom by understanding how ADHD can be married with an award for Quality Teacher Status.Section 2b Part Two Examination of the Practical Implications for Primary School TeachersSection 3.2.4 of the Standards for the Award of Qualified Teacher Status declares that teacher should, identify and support more able pupils, those who are working below age-related expectations, those who are helplessness to achieve their potential in learning, and those who experience behavioural, emotional and social difficulties. Clearly, therefore, with regards to pupils with ADHD, the most pressing concern for primary school teachers is the need to maintain a salutary social balance within the classroom without ostracising the child with the learning difficulty. Inclusiveness must consequently be the teachers main priority if they are to replete the most basic precept of the QTS. All children need someone to mediate their learning, but sometimes this feels especially true for children with special educational needs. (9)This is a move and tested educational tightrope that cannot be replicated in a college classroom, in an academic book or in an educationspecific journal. Rather, this challenge can only be met through experience. This is, of course, not to state that there are not certain features and attributes that the teacher can learn so as to be in a more advantageous position to deal with potential sufferers of ADHD. The most obvious place to begin would be the acquisition of help from a more experienced teacher one who hopefully has coped with the demands of teaching children with learning difficulties beforehand, even if the difficulty in question is not ADHD. This would equip the recently quali fied primary school teacher with the ability to deal more efficiently with children in the classroom who have already been diagnosed with the illness as well as those pupils that have yet to be diagnosed but who are nonetheless showing a variety of signs of ADHD. This is an important point because, according to the guiding principles for the diagnosis and treatment of attention-deficit hyperactivitydisorder, ADHD should be suspected but never presumed. (10)Section 2.4.1 of the Standards for the Award of Qualified Teacher Status states that they the qualified teacher understand how pupils learning can be affected by their physical, intellectual, linguistic, social, cultural and emotional development. With regards to pupils with ADHD, this would involve the ability to liaise with the childs parents. This has two obvious benefits. The first is to better understand the childs home life, which experts agree is a vital factor in the formation of the disease, especially if said home life i s noticeably chaotic, abusive or violent. More regard should be effrontery to a childs social circumstances, experience and history in understanding their behaviour.(11) Secondly, research has indicated that there are certain generic attributes of ADHD that run through families, which makes the issue of maintaining an effective, coherent working dialogue with the parents of ADHD sufferers all the more imperative (12). Although the illness is inherently complex, involving a crossover of many genes, there is a strong likelihood that one of the parents will also show signs of ADHD, making empathy with the child easier in the process.The Standards for the Award of Qualified Teacher Status also require the primary school teacher to be able to effectively plan lessons for all pupils in the class. Moreover, as of January 2002, a revised SEN code of practice dictated that all teachers are SEN teachers.(13) Clearly, children with learning difficulties pose unique problems for the planning o f lessons, none more so than those pupils with ADHD, which is an inherently disruptive and antisocial illness. Communication between the teacher and the student (not to mention communication between the student and his classmates) is therefore a major problem. Fortunately, there are a number of study aids that are available for teachers to consult. For instance, the official ADHD website in the US offers invaluable advice on how best to manage children with the illness in a classroom setting (14). The following constitutes a small extract of what the organisation considers to be useful information for educators. It should be interpreted as an Individual Education Plan (IEP)Refrain from popping a question which requires a speedy answer.Give the student extra time to answer questions. For example, use up time by writing on the blackboard.Speak slowly and provide information in small units. This is especially utile in the classroom.Reinforce verbal instructions and lessons with writte n materials, or by writing on the blackboard.Work closely with the student to determine and accommodate his or her individual needs.There are likewise a number of books that have been published in recent years that are a source of encouragement for primary school teachers. Mark Selikowitz, for example, gives advice on the structural planning of the classroom for students with ADHD the child with ADHD should be seated at the front of the class near to the teachers desk. The old idea of putting the naughty child at the back of the classis totally inappropriate if the child has ADHD. (15)Teachers must also be constantly aware of the dangers inherent in educating children who are prescribed powerful doses of medicine. In his critique of the culture of prescription drugs prevalent in the USA and the UK, David Stein warns of the sideeffects of Ritalin, which include insomnia, tearfulness, rebound irritability, personality change, nervousness, anorexia, nausea, dizziness, headaches, heart palpitations, and cardiac arrhythmia. (16)Finally, in accordance with Section 3.3.1.4, tutoring a child with ADHD allows the qualified teacher to test their ability to effectively manage instances of bullying and harassment. Where a child with ADHD is concerned, bullying is especially relevant due to the potentially volatile outbursts of the child in question as well as taking into account the reaction of those classmates who do not understand ADHD. As is the case when constructing an IEP, the primary school teacher must be able to use common sense in order to properly tailor classroom and playground management for the specific needs of the child in question. No two ADHD sufferers are likely to display the same characteristics of the disease.Section 3 Copies of Extracts(1)(4)Rebels without a cause Children with behaviour problems are increasingly diagnosed with ADHD. But their parents often struggle to get them the education they need. By Katharine Quarmby Tuesday December 6, 2005 The Guardian James Steele, aged 10, from Bermondsey, in the south London, has seven doses of Ritalin a day to control his behaviour. On one of his first days at Southwark Park primary school, he stripped off naked and was chased round the school by two teachers. His mother, Julie Clapp, had to give up work to cope with him. Its been a nightmare, she says.He would crawl over desks, catch climbing on equipment in the classroom, says Angie Sharma, acting headteacher. Then at one point he opened the window and stood on the ledge. The whole school was in a panic. We seriously thought we might have to exclude James. It was extremely difficult for the teacher to teach to the national curriculum when James was running out of class, refusing to co-operate.Before he joined the school, he had already been kicked out of nursery. The school begged Southwark council for help and, at the age of seven, James was diagnosed with attention deficit hyperactivity disorder (ADHD) and given a statement of special educational need. A team of experts assessed James, including the schools special educational needs co-ordinator, an