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cupid4714
17-11-2002, 11:53 PM
to brudders

any1 have any ideas where to chk for n how to chk for STD? is it done in normal clinics or polyclinics? n roughly hw much would it cost?

pat888
18-11-2002, 12:06 AM
go kelantan lane.....$ i dunno

joker85
18-11-2002, 07:13 PM
poly clinics

cupid4714
19-11-2002, 01:48 AM
btw i meant is STD nt aids n hw much?
thx

joker85
19-11-2002, 01:09 PM
not sure

tora69
19-11-2002, 08:06 PM
Non-gonococcal urethritis (NGU) occurs worldwide and is the most common sexually transmitted disease (STD) seen in the Department of STD control (DSC) clinic in Singapore.

NGU is an infection of multiple aetiology. Chlamydia trachomatis is recognised as the major source of NGU in men, being detected in 30% to 50% of patients(2). Infections caused by Chlamydia trachomatis are amongst the most common bacterial STDs in the world, causing substantial morbidity in young sexually-active people and is the most frequent identifiable single cause of pelvic inflammatory disease and infertility. In two previous local studies, the rate of isolation of Chlamydia trachomatis in cases of NGU in male patients ranged from 13.8%(3) to 30.2%.

The current treatment of choice for NGU and Chlamydia trachomatis cervicitis in our clinic is doxycycline, given for 7 days. Patient non-compliance is a problem, and this is particularly significant in patients and sex workers with asymptomatic infections.

Azithromycin is a new, long-acting azalide antibiotic which has been shown to be effective in the treatment of Chlamydia trachomatis infections(5,6). Its single dose usage is advantageous, and arises from its interesting pharmacokinetic properties. In contrast to low serum levels, high and sustained concentrations are achieved in a variety of different tissues, including the urogenital tract(7,8). The aim of this study was to compare its efficacy and side effects with doxycycline in treating NGU in males and culture proven Chlamydia trachomatis infections in female sex workers, as well as to identify differences in follow-up rates and the risk of reinfection in male patients who were treated.

MATERIALS AND METHODS

Study population

The study was carried out at the DSC clinic in Singapore, in two parts: (1) male patients, aged 18 years or more, presenting with symptoms and signs of acute urethritis were examined, and recruited if they had NGU as defined by 5 or more white blood cells per high power field (WBC/hpf) in the microscopic examination of a Gram-stained urethral smear, and (2) female commercial sex workers on the Medical Surveillance Scheme were identified based on a positive Chlamydia trachomatis EIA screening test. Only female sex workers who had a positive endocervical swab for Chlamydia trachomatis culture were analysed.

Gonorrhoea was excluded by the absence of intracellular Gram-negative diplococci and by negative culture on modified Thayer-Martin medium. Exclusion criteria included consumption of antibiotics in the previous 2 weeks, a known allergy to either drug, concurrent treatment with ergotamine or carbamazepine, and a history of chronic diarrhoeal disease which might interfere with absorption.

Procedure

Urethral smears were taken by means of cotton-tipped urethrogenital swabs inserted 3 cm into the urethra. For females, endocervical swabs were taken after wiping the cervix with a cotton swab. Specimens were taken for Gram-stained smears, gonococcal cultures and Chlamydia enzyme immunoassays (EIA) for detection of Chlamydia trachomatis antigen. In addition, for the female sex workers, specimens were sent for cultures.

Chlamydia trachomatis antigen was identified by EIA (Chlamydiazyme diagnostic kit, Abbott Laboratories, Abbott Park, Illinois). Specimens collected were analysed within 48 hours. One mL of specimen dilution buffer was added and vortexed for 3 cycles of 15 seconds each. Immediately after vortexing, 200 uL of the specimen was pipetted to each well with one bead added, and incubated at 37°C ± 2°C for 60 minutes. The liquid was aspirated and each bead washed 4 times with 4 - 6 mLs of deionised water for a total rinse volume of 11 - 17 mLs. Two hundred uL of anti-Chlamydia trachomatis and 200 uL of enzyme conjugate were pipetted sequentially into each well and incubated at 37°C for 60 minutes. Three hundred uL of OPD (o-phenylenediamine) substrate solution was added for colour development and incubated for 30 minutes at room temperature. The reaction was stopped by adding 1 N sulphuric acid and the absorbance read in a spectrophotometer.

Chlamydia trachomatis cultures were performed by inoculating specimens onto cycloheximide treated monolayers of McCoy cells on cover slips in glass vials. Culture is considered positive if the monolayers contain one or more chlamydial inclusions, identified by its typical crescent shape and intracytoplasmic location.

Consecutive patients were openly assigned to one of each treatment group on an alternating basis. Patients assigned azithromycin were given 1000 mg of the drug under supervision at the clinic, and those assigned to the doxycycline treatment arm were prescribed doxycycline 100 mg bid for 7 days. Male patients were told to return at weeks 1, 2 and 4 post treatment. Female sex workers were assessed at weeks 1 and 2 post-treatment. At each visit, a record of the patient’s symptoms and signs and any side effects were recorded. A urethral or cervical smear was also done. Chlamydia EIA tests and cultures were done weekly at 0, 1 and 2 weeks in female patients and during the first visit and after 2 weeks in male patients. Male patients were dropped from the study if they did not return for the first two follow-up visits, while the last follow-up visit was used to assess their risk of reinfection and relapse following a clinical cure. No additional treatment was given until the assessment at week 2, where failure to achieve clinical cure was regarded as treatment failure.

Analyses

Clinical cure for male patients was defined as a normal urethral smear (l 5 WBC/hpf) with resolution of symptoms and signs of urethritis. Microbiological cure for males was defined as a negative EIA result if the initial one was positive, while for the females, microbiological cure was achieved if the repeat culture after treatment was negative for Chlamydia trachomatis. Reinfection was defined as a recurrence of signs and symptoms of urethritis after a cure was achieved, coupled with a history of re-exposure during the follow-up period. A relapse was defined as a recurrence of signs and symptoms of urethritis following achievement of cure without any re-exposure during the treatment and follow-up period. Only male patients were assessed for reinfection and relapse rates. Fisher’s exact probability test was used for statistical analysis, and p l 0.05 was considered statistically significant.

tora69
19-11-2002, 08:27 PM
Anonymous HIV Testing & Counselling Centre


This is the only place where anonymous tests is available in Singapore. Experienced counsellors are on-hand to provide pre- and post-test counselling for our clients. Immediate HIV tests are available. Instead of waiting a few days for the result, it only takes 30 minutes at this test site.

The DSC Clinic
Blk 31, #02-16
Kelantan Lane
Saturdays from 1 to 4 pm and
Wednesdays from 6.30 to 8pm.

cupid4714
20-11-2002, 01:00 AM
thx guys another tupid question
i tot the 1 inkelantan onli deal wif aids
do they also chk for other kidna of std disease?