7 Common Causes Of Anal Itching

Anal itching, also known as pruritus ani, is a common condition. Some studies have shown that it can affect as much as 1-5% of the population.The reason why cases of anal itching are not always relieved with scratching is because of a self-propagating itch-scratch cycle: the scratching exacerbates the inflammation, causing an irresistible urge to scratch even more.There are many causes of anal itching.

Here are 7 broad groups of conditions that can present with anal itch.


1. Dermatologic conditions

Topical irritants such as Deodorants, Detergent/fabric softener, Hemorrhoid remedies, Soaps, Suppositories, Talcum powder, Tight clothing and Toilet paper dyes and perfumes can cause Irritant dermatitis leading to itching. Atopic dermatitis, Hidradenitis suppurativa, Lichen planus, Lichen sclerosis, Psoriasis and Seborrheic dermatitis are all conditions that can cause anal itch.

2. Dietary irritants

Certain types of foods, when ingested, can become dietary irritants when passed out from the other end. They include foods such as Beer, Caffeine, Chili peppers, Citrus foods, Milk and Tomatoes.

3. Anal conditions

Such as Anal fissures, Chronic constipation, Chronic diarrhoea, Fistula, Incontinence, Prolapsed haemorrhoids, Rectal prolapse, Irritable bowel syndrome, Inflammatory bowel conditions and Skin tags.

4. Infections

Abscesses, Candidal infections (intertrigo), Corynebacterium minutissimum (erythrasma), Molluscum contagiosum, Parasites (e.g., pinworms, scabies), Staphylococcus aureus infections can cause anal itch.A big group of infections are sexually transmitted infections. These infections have to be considered especially in people who partake in anal intercourse.Some of the infections include Chlamydia, Gonorrhoea, Herpes and Human papillomavirus to name a few.

5. Malignancies/Cancers

Such as Bowen disease, Extramammary Paget disease, Squamous cell carcinoma can present with itch.

6. Medications

Such as Chemotherapy, Colchicine, Neomycin and Quinidine can trigger itch too.

7. Systemic diseases

Aplastic anaemia, Diabetes mellitus, Inflammatory bowel disease, Jaundice, Leukemia, Lymphoma and Thyroid disease can have anal itch as a symptom. In many instances, we may not actually identify any specific cause and label the itch as idiopathic pruritus ani. The itch could also be due to psychological disorders.While many people worry that anal itch is due to a sexually transmitted infection, as you can see above, there are so many reasons why a person may develop an anal itch.

Diagnosis

The most important thing is to seek medical attention so your doctor can assess you and come to a diagnosis.The doctor will take a detailed medical history from you and do a physical examination, including an examination of your perineal area and possibly do a proctoscopy. If need be, we may do some swabs to send off for investigation. The doctor may advise for further investigations such as a colonoscopy depending on what is found and your age group.

Treatment & Prevention

Treatment of pruritus ani should address the underlying cause. The goal of treatment is also to prevent further irritation and moisture in the affected area and avoiding scratching. Patients should be aware of proper hygiene and avoidance of perfumes, dyes, dietary irritants (especially caffeine), and tight clothing.Patients should also keep the area dry and be aware of the itch-scratch cycle. A sedating antihistamine can reduce scratching during sleep. If the itch is very bad, wear cotton gloves or socks on the hands at night to prevent scratching. Patients with hemorrhoidal skin tags that make hygiene difficult can clean the area using a handheld showerhead, squirt bottle, sitz bath, or a bidet. After which, pat the area dry or use a hairdryer set on “cool.” Avoid using soap on the anal area as the skin there is sensitive and can dry out easily. Do not scrub the perineal area with anything including toilet paper.Besides the conservative measures above, low-potency topical steroids can be used for a short duration of time. If the itch persists after treatment, a biopsy can be considered.If you wish to speak to our doctors about the following symptoms, please call us or email us for an appointment at hello@dtapclinic.com

Let’s Size it UP: Truth behind penile enlargement

Penis size has always been something that men are preoccupied with. Most men think that bigger is better. It is also directly linked to their self-esteem and self-confidence. Some men get self-conscious when they’re in the changing room comparing themselves with other men who apparently have bigger penises.  Some even feel that if they are not big enough they may not be attractive to the ladies or adequately satisfy their partners. That is why if you search on the internet for penile enlargement, you will get a lot of different products and services listed in order to help you achieve it. The products include things like pills, creams, massage oils, injections and even surgery. The question is do they really work? Or are they just banking on men’s’ fears and obsessions?

In this article, I will explore some of the popular treatment options available and see if it really works or is it just a waste of your money.

What is normal size?

First of all, let us establish what is considered normal. Do some men feel that they are small, but are they really? Many studies have shown that men who think their penises are small actually have normal-sized penises. It is only considered small if the Stretched Penile Length (SPL) is less than 7cm or 2.8 inches. This is measured from the base of the pubic region to the tip of the penis when it’s stretched. Anything longer than this is considered normal size.

Penis enlargement products:

Pills, creams and lotions

These products usually contain herbs or ingredients that manufacturers claim help to increase penile length. Actually most of them only supposed to help to improve blood flow to boost erection. It doesn’t really change the actual penis size or length.

Vacuum pumps

These pumps work by drawing more blood into the penis causing the penis to swell and get engorged. It might make the penis appear bigger temporarily but prolonged use may damage the tissues in the penis and may cause the erections to be less firm.

Exercises

This is similar to penis massage and sometimes are called jelqing. Using both hands to massage the penis to improve blood flow and hoping to increase the length. This technique may be safer but it is not scientifically proven to work. If not done properly may cause pain  or injury to the penis.

Procedures:

Filler injections

Some clinics in other countries offer filler injections using ingredients like Hyaluronic Acid which is typically used to even out wrinkles. A few small scale studies have shown temporary improvements in penile length and size. However bigger studies are required to establish its efficacy and currently it is not a medically approved procedure in Singapore.

Penile surgery

This would be the most extreme method of penile enlargement. There are different techniques done by different surgeons. So far this is the only proven method of penile enlargement. However, there are several potential risks and complications to consider.

Extracorporeal Shockwave Therapy

This procedure works by applying low-intensity shockwave to the penis. This helps to increase blood flow and circulation. Some patients experience bigger girth due to the increased blood flow but no change to the penile length. 

Important things that you can do:

Seek medical consult

Speak to a doctor who can advise you whether you have a small penis and what would be suitable for you.

Talk to your partner

You may feel inadequate but your partner may not have any problems with it. Communicate this to your partner so you can discuss what’s best for you. It may not be about size but could involve certain sexual preferences.

Lose weight

Most of the time, the penis may appear smaller due to excess belly fat. After losing weight especially around the tummy area, your penis will appear longer and more obvious.

Trim your pubic hair

A thick bush may make your penis appear hidden and hence smaller than it actually is. Trimming the pubic hair helps to reveal more of it and make it appear longer or bigger.

Bottom line:

Many men believe that increasing the size of their penis will make them more of a man, more attractive or better in bed. However, it’s highly likely that their penis is within the normal range.

Even if you want to make it bigger, there are no proven ways to do it without risk or complications.

Most of the time it boils down to your own perception about what the size of the penis means to you and your partner. So do speak to a doctor or a healthcare professional to ascertain where you lie with regards to penis size and what is best for you. 

DTAP Clinic Receives Sensitivity Training for Working with LGBT+ Patients

Singapore, date – Regional GP+ group DTAP Clinic recently attended its first sensitivity training on working with LGBT+ patients. The online training workshop was conducted by Oogachaga and the T Project, attended by more than 60 doctors, nurses and support staff from Singapore and Malaysia. The responses from the workshop participants were positive and encouraging. 

The training focused on debunking common myths and assumptions as well as teaching good communication techniques for medical professionals in clinical and support scenarios when treating and consulting for LGBT+ patients. Response from the workshop participants was positive and encouraging. 

Better doctor-patient communication with the LGBT+ community

Mr. Leow Yangfa, a registered social worker and executive director of Oogachaga kicked off the training with the first session addressing various commonly held misconceptions and misheld beliefs regarding LGB individuals. He shared with DTAP Clinic’s professionals Oogachaga’s professional expertise and experience when working with Singapore’s LGBTQ+ community. The group commended DTAP Clinic as a valued and important private healthcare provider for many LGBTQ+ individuals, couples and families in the community.

“All our DTAP Clinics have always been committed to providing a safe space for everyone, regardless of race, religion, gender or orientation. Our ethos is to comfort, reassure and treat every patient with a uniform high standard of care. We are extremely happy to have undergone this training with Oogachaga and the T Project. All of us learned a great deal and truly enjoyed the course,” said Dr Tan Kok Kuan, CEO, DTAP Clinic Group. 

Facts and Bad Assumptions

The second part of the training was conducted by Mr Keeshan Menon, a registered social worker with post-graduate credentials in social work and psychology, and Ms. June Chua, founder of the T Project. Their talk provided key insights into the concept of the continuum of sexuality and the pitfalls of making assumptions. The session was enlivened with positive engagement with questions from the audience and answers from panel. 

“I found this course really useful. Now I understand how certain things I may unintentionally say can be misunderstood by patients. I am more aware on how best to talk to patients and colleagues,” said Joel Wong, a staff from DTAP Clinic.

Aside from empowering all DTAP Clinic staff with the skills to put LGBT+ patients at ease, the course also helped with DTAP Clinics’ internal engagement and communication. The staff and doctors felt more confident and aware of using socially accepted terms and vocabulary when communicating with each other with regards to patient care, avoiding pitfalls when communicating with colleagues, especially with DTAP’s stand on equal opportunity employment. 

“This course has made all of us at DTAP Clinics much more aware of how we can communicate with patients and each other. It was extremely useful and practical and we plan to attend equitable courses for our staff regularly,” said Dr Tan Kok Kuan, CEO, DTAP Clinic Group. 

About DTAP clinic

Established in 2005, DTAP (Dr. Tan & Partners) clinics, a pioneer of GP plus, or “General Practice with Special Interest” model in Singapore, provides holistic and comprehensive medical care for everyone. We provide basic GP services with a key focus in HIV & STD testing and management, Men’s Health (Andrology), Women’s Health and Chronic Disease Management services. Our clinics are located in Singapore & Malaysia.

10 Things about HPV (Video)

HPV stands for human papillomavirus. HPV is usually harmless and goes away by itself, but some types can lead to cancer or genital warts.

 Here are 10 things about HPV.

1. HPV is incredibly common.

and It is estimated that 8 out of 10 people will get HPV at some point in their lifetime


2. Next… How is HPV spread?

HPV is one of the most common STI and is spread through genital or skin-to-skin contact. The virus can be spread even when no symptoms are evident.


3. The third point is that HPV doesn’t necessarily stay with you forever.

Patients commonly assume that HPV is a lifelong infection that will stay with them always. Most HPV infections clear up on their own and do not cause any problems. However, overtime persistent infection by certain HPV types can cause cancer and other diseases such as warts.


4. There are many strains of the virus.

HPV is not just one virus, but consists of over hundreds straina . Each virus is labeled with a number to distinguish it from the others, and different viruses can target different areas of the body, causing differentdiseases in humans.

HPV is most commonly associated with a risk for certain cancers, including cervical cancer, or oral cancers which involves, the base of the tongue or tonsils. 


5. Next in Cervical cancer

HPV causes more than 99% of cervical cancer cases and Approximately 400 new cervical cancer cases are diagnosed annually in Singapore.  

Cervical cancer ranks* as the 8th leading cause of female cancer in Singapore.


6. In Detection of HPV

A pap smear test is a cervical cancer screening tool that is commonly use to detect cervical cancer or pre-cancerous changes in the cervix.

A more sensitive test like the HPV DNA test can be used to detect certain high risk strains of HPV that can lead to cervical cancer


7. HPV in Men

Men can get HPV and pass it to their partners. HPV has been shown to increase the risk of anal cancer, penile cancer , oral and throat cancers in men.


8. There Is Also a Vaccine that Can Protect You

The HPV vaccine has been shown to be highly effective in protecting people against cervical cancer and warts..

Individuals already infected with HPV should still get vaccinated because the vaccine may protect against additional strains of hpv. However, for maximum benefit, vaccination should occur before an individual becomes exposed to the virus.

Thus it is recommended for preteens to get the vaccine at an early age.

Recently the US Food and Drug Administration expanded its approval of the HPV vaccine to include men and women up to 45 years old As an effort to protect more people from several types of cancer caused by HPV.


9. After HPV Vaccination…

Women should continue to get regular Pap screenings because the vaccine though reduces risk of cervical cancer, does not protect against all HPV types.


10. To Sum Up HPV

The best thing you can do is stay proactive and look after your well-being.

“HPV is something both women and men should be aware and well-informed about, protecting yourself and your loved ones,”

Make An Appointment Find A Doctor

CD4 Count VS Viral Load – What do you need to know?

The Immune system is made up of a large network of cells that work together to combat infections. Helper T Lymphocytes are a particular type of immune cell that expresses a molecule called the Cluster Determinant 4 (CD4). Helper T lymphocytes are hence commonly known as CD4 cells. The Human Immunodeficiency Virus (HIV) selectively targets CD 4 cells and uses them as hosts for viral replication. As the virus replicates, it destroys its host cell as it releases new copies of the virus. Therefore, as the viral load (which is a measure of the amount of virus present in the body) increases and the host CD 4 cells will decrease. 

HIV Pro Viral DNA Test

HIV Infection

During the early stages of a HIV infection, viral replication occurs at a very fast rate at the expense of CD 4 host cells. A vicious cycle occurs, wherein an increase in HIV viral load attracts more CD4 cells which get infected and become hosts to further increase the viral load. Within the first few weeks of a HIV infection, the CD 4 count falls precipitously. Such a sharp fall in CD4 cells is the hallmark of a HIV infection. 

Upon diagnosis of HIV, it is crucial that the patient’s CD 4 and viral load are measured. The CD 4 count allows the medical team to determine the state of the immune system and plan the appropriate treatment. If the CD 4 count is below 200 units, the diagnosis of Acquired Immunodeficiency Syndrome (AIDS) is established. AIDS is a serious complication of HIV infection and can be fatal, therefore, if the patient is diagnosed with AIDS he/she requires immediate medical attention in a hospital.The viral load will give an indication of how fast the virus is replicating. Current medication used to treat HIV infection targets different parts of  viral replication and interfere in the process of new viruses being produced. Therefore, a fall in viral load after commencing medication is an indicator that the medication is working. 

People Living With HIV

For People Living with HIV (PLHIV), the main goal of therapy is to increase CD4 cell numbers and decrease the viral load to an undetectable level. Monitoring these 2 parameters will guide the treatment regime. In general viral load is measured 2 weeks after starting medications for HIV, then at 4 to 8 week intervals. The expected fall in viral load should be to approximately < 500 copies/ml by week 8 – 16 and < 50 copies /ml by week 16- 24. CD 4 recovery is slower, the first CD4 test is done 3 months after commencing treatment and every 6 months after. In general, a CD 4 count > 300 cell/uL with a low viral load is a good level to ensure that PLHIV does not encounter any opportunistic infections.

Also read: U=U: Science, Not Stigma

CD 4 and Viral load measurements are essential parameters in guiding the medical therapy for PLHIV. Regular check of these parameters ensure that PLHIV are able to maintain an active lifestyle and avoid any infections that may occur due to a lowered immunity.

HIV Screening Singapore


Detox Teas – Do They Work?

Detox teas are a controversial topic. For thousands of years, humans have been trying to rid their bodies of what they believe are toxins. Some historic “detox” practices include bloodletting, enemas, sweat lodges or saunas, fasting, and drinking herbal preparations. Some of these practices were even accepted as medical treatments before the advent of modern medicine. In the age of social media, you might have seen celebrities or even your friends posing with a pack of detox-tea on Facebook or on Instagram.

Detox teas are usually a mixture of tea leaves and other natural ingredients like berries, fruits, spices, herbs and roots.


Do detox teas actually help to detox the body?

Tea is generally considered healthy. Multiple studies over the years have shown an association with tea and health benefits including cardiovascular health, blood pressure regulation, mood regulation, mental performance and maintenance of weight and energy levels too. Tea contains tea flavonoids, polyphenols, in particular catechins and epicatechins and antioxidants which health benefits are still being studied and validated. Whether or not teas slapped with a detox label does what it actually says – remove toxins – is still very debatable. 

The additional natural ingredients may also have health benefits. Many ingredients of traditional medicine are currently being investigated scientifically, and some of them have been shown to have health benefits. 


Real weight loss or just a loss in water weight? 

Most of these detox teas do contain tea leaves, and tea does have caffeine. Caffeine is known to be a stimulant which can raise your metabolism. Caffeine can also act to suppress your appetite. Through such a mechanism, you might enter a caloric deficit by burning more calories, and eating less. This kind of weight loss is true weight loss. 

However, certain detox teas do contain supplements which act like laxatives, or medical laxatives itself. The effect of these laxatives are claimed as colon cleansing, which is often recommended as part of a detox plan. Such laxatives can cause cramping, bloating, nausea and vomiting. Dehydration and electrolyte loss can also be a concern. Such a weight loss is mainly water weight loss, and is not healthy, nor sustainable. 


Side effects or dangers of detox teas?

The detox teas that are conservative mixes of tea leaves and natural products are usually not more dangerous than regular teas. However some detox teas may include, in large amounts, natural products that have a prominent biological effect on our body. Some brands may also have additional chemical ingredients that could harm your health.

As mentioned above, diarrhea could be a side effect of these teas. These may be from the laxative effect of natural plant-based sennosides, or actual laxative medications. Excessive diarrhea can lead to dehydration and electrolyte loss, which may leave you lethargic and weak. Some compounds, including caffeine, are also diuretic, which can cause you to pass more urine than normal. Severe diarrhea and dehydration has led to death, so this is a side effect of concern. 

Appetite suppressants or stimulants like caffeine are commonly found in detox teas. Ingesting too many stimulants may leave you irritable, unfocused and jittery, similar to when you drink too much energy drinks. You may also suffer from insomnia if these teas are taken too late in the day. Illegal stimulants like ephedra and medications such as ephedrine have been found in detox teas. These may trigger heart attacks, strokes, seizures and cause even death, especially in people with pre-existing medical conditions. 

Diabetic medications that lower your blood sugar level have been found inside detox teas. People who are on detox teas may also be eating less, contributing to a lower blood sugar level. Such a situation can lead to hypoglycemia, where the sugar level in your blood is dangerously low. This can lead to sweating, confusion, shaking, loss of consciousness and even death.

Some of the herbs that are inside detox teas may have drug-drug interactions with the medications that people are currently taking, raising the levels of the medication in your body to toxic levels. Some herbs themselves if ingested in large enough quantities, may also put strain on your kidney and liver. This has the opposite of detoxing your body, poisoning your body instead. 


Are there any benefits to detox teas?

Not all detox teas are harmful. Tea itself does have health benefits. The other natural ingredients (in conservative amounts) may also serve to improve your health. But please use it with caution and moderation. These teas, if used, should be incorporated into a healthier lifestyle.


Is it healthy to consume detox teas long-term?

The manufacturers themselves do not recommend taking detox teas in the long run. If you do decide to try out a detox tea, stick to the recommended serving guide, and be vigilant about any side effects that may occur. If these side effects are causing you any discomfort, it is recommended that you stop. 


What are some recommendations for detoxing the body in place of consuming detox teas?

The human body is more than capable of clearing out waste products for the vast majority of us. This is what our bodies have evolved to do to keep us alive. Our kidneys, liver, cardiovascular system, gut and skin are all working hard every day to process all of the substances that we come in contact with, and they do a good job at it. The best thing to do is to not add additional burden to the body. 

The very fact that you are considering a detox tea means that you are willing to do something to change your lifestyle for the better. Use this motivation to kick start good habits. The detox tea can be the spearhead in the charge to a better you. 

Also read: Weight Loss Treatment

An overall healthy and balanced diet with whole grains, fish, fruits and vegetables, and less red and processed meat is a key component to a healthy life. Processed foods have been shown to be poor in nutrition, laden with salt and fat and contribute to obesity and cardiovascular disease. Unprocessed and minimally processed foods on the other hand are packed full of nutrition, keeps you full for longer and is essential for your bodily functions. Try and limit the frequency and amount of processed foods to a minimum.

Physical activity and exercise is just as important as the quantity and quality of food. The Health Promotion Board of Singapore recommends 150 minutes of moderate intensity, or 75 minutes of vigorous intensity physical activity a week. Health benefits of regular physical activity include a 20 – 50% reduced risk of premature death, incidence of coronary heart disease, type 2 diabetes, depression, stroke, high blood pressure, colon cancer and breast cancer, to name just a few. If you are just starting to get into more physical activity, it is always advisable to start slow and ramp up your physical activity slowly. This will help minimize musculoskeletal injuries. The lack of time should not be an excuse to pass on both healthier food options and exercise

It is also advisable to drink lots of water. Water makes up about 60% of our body weight and is essential for our survival. Water gets rid of wastes through urination, perspiration and bowel movements. It keeps your temperature normal, lubricates and cushions joints, protects organs and tissues and maintains the electrolyte balance in our body to name just a few. This is the form of detox that definitely has no opponents. 

Getting enough sleep every night is essential as sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your mental health, physical health and quality of life. Sleep is the time where the body and brain heals itself and recharges for the next day. Sleep deprivation has been shown to be associated with chronic diseases, decreased mental and physical performance and even reduced immune function. 

Just remember that there are no shortcuts to a healthy lifestyle. That however should not stop you from living the best life. 

Join our Telegram for medical news and health tips: https://t.me/dtapclinic

*Parts of this article were first published in CLEO.

Bagaimana jangkitan HPV dan masalah kesihatan yang disebabkan olehnya boleh dicegah?

Apakah itu human papillomavirus (HPV)?

HPV adalah virus yang boleh menyebabkan penyakit kelamin (sexually transmitted disease, STD) dan adalah penyakit STD yang paling kerap berlaku di dunia. Jangkitan HPV dianggarkan berlaku di kalangan sekurang-kurangnya 80 peratus wanita dan lelaki yang telah bermula hubungan seks.  

Apakah gejala atau simptom jangkitan HPV?

Kebanyakan orang yang dijangkiti HPV tidak mempunyai apa-apa gejala kerana sistem ketahanan (imun) badan dapat menyingkirkan virus HPV sebelum apa-apa gejala berlaku.

Walaubagaimanapun, bagi individu yang mempunyai simptom, ketuat (genital warts) boleh dilihat di kawasan alat kelamin. Ketuat juga boleh dilihat di kulit (non genital warts) kerana HPV disebarkan antara kulit. Ketuat kebanyakkanya disebabkan oleh HPV jenis 6 dan 11. HPV jenis berisiko tinggi (high risk strains) boleh menyebabkan penyakit barah di cervix, dubur (anus), vulva dan faraj, zakar dan juga dalam mulut dan tekak (oropharyngeal).  

Bagi penyakit barah cervix peringkat awal, simptom-simptom adalah lelehan faraj berdarah di luar masa haid, selepas menopaus atau selepas hubungan seks. Lelehan faraj yang mungkin berbau juga adalah antara simptom barah cervix.

Bagaimana seseorang boleh dijangkiti HPV?

HPV adalah virus yang boleh dijangkiti melalui sentuhan kulit, melalui hubungan seks (sama ada melalui vagina, oral, zakar atau lubang dubur) atau melalui sentuhan kawasan genital (alat kelamin). Individu tidak boleh dijangkiti HPV melalui sentuhan objek contohnya tempat duduk tandas. 

Disebabkan virus ini boleh dijangkiti melalui hubungan seks, jika individu mempunyai beberapa pasangan seksual, risikonya ditingkatkan. Tambahan pula, kondom hanya memberi perlindungan yang tidak sepenuhnya. Pengisapan rokok juga boleh meningkatkan risiko jangkitan HPV sebanyak 4 kali ganda, bersama juga jika individu mengambil ubat yang melemahkan sistem imun atau mempunyai penyakit yang melemahkan sistem imun. 

Apakah komplikasi penyakit jangkitan HPV?

Seperti dijelaskan di atas, HPV boleh menyebabkan penyakit barah di cervix, vulva, faraj, zakar atau lubang dubur. Ia juga boleh menyebabkan barah tekak, lidah dan tonsil. 

Jenis HPV yang menyebabkan penyakit ketuat tidak sama dengan jenis HPV yang menyebabkan barah. Penyakit barah yang disebabkan oleh HPV selalunya mengambil jangka beberapa tahun untuk berlaku.

Bagaimana jangkitan HPV dan masalah kesihatan yang disebabkan olehnya boleh dicegah? Apakah rawatan penyakit jangkitan HPV?

Vaksin terhadap HPV adalah sangat digalakkan. Vaksin HPV adalah selamat dan berkesan. Keberkesanan vaksin ini adalah setinggi 97% di kalangan individu yang tidak pernah dijangkiti HPV. Vaksin juga bermanfaat jika penerima sudah dijangkiti HPV. 

Jika individu menghidap barah yang disebabkan oleh HPV, rawatan yang diberikan termasuk pembedahan, kemoterapi dan radioterapi.

STDs: Apakah Simtom HIV Dan STD?


Doktor yang boleh berbahasa melayu


Dr. Taufiq at DTAP Clinic @ Somerset

1 Grange Rd,
#10-08 Orchard Building,
Singapore 239693

Telepon: +65 6262 0762

Dr. Ezlyn at DTAP Clinic @ DUO Galleria

7 Fraser St,
#B3-18 DUO Galleria (Bugis MRT), 
Singapore 189356

Telepon: +65 6976 5023

Chlamydia Conjunctivitis

Chlamydia is a sexually transmitted infection (STI) caused by the bacterium Chlamydia Trachomatis. It is one of the most common STIs worldwide, and likewise here in Singapore. According to the latest statistics provided by the Department of STI Control (DSC) Clinic, there were officially 2,719 newly diagnosed cases of Chlamydia reported in 2018.

It is well known that Chlamydia affects the genito-urinary system, with the typical symptoms being painful urination, increased urinary frequency or urgency, penile or vaginal discharge, testicular pain or swelling in men, and painful sex or bleeding after sex in women. You may also be aware that Chlamydia can sometimes be completely asymptomatic. However, what most people may not know is that Chlamydia can affect other parts of the body as well, namely the eyes, rectum, throat and joints.

In this article, we will focus on Chlamydia eye infection, also known as Chlamydia Conjunctivitis. You can read more about Chlamydia as an overall topic in a previous article:


What is Chlamydia Conjunctivitis?

Conjunctivitis is inflammation or infection of the conjunctiva, a clear membrane that covers the white part of the eye and lines the inside of the eyelids. The conjunctiva helps to lubricate the eye by producing mucus and tears, and prevents the entry of microbes into the eye. The various causes of conjunctivitis include viral or bacterial infections, allergies, chemical irritation and foreign objects. Therefore Chlamydia Conjunctivitis refers to conjunctivitis resulting from a Chlamydia infection.

How does Chlamydia Conjunctivitis occur?

Chlamydia Conjunctivitis is directly spread from the bacteria entering the eyes. This usually happens from touching or rubbing your eyes after touching your genitals (if you have Chlamydia) or those of an infected partner. It is also possible to get infected from sharing towels, eye makeup or cosmetics that contain the bacteria.

Signs and symptoms

Chlamydia Conjunctivitis can present acutely, but more commonly patients have mild symptoms for weeks to months. The majority of cases affect only one eye, and vision is usually unaffected.

Signs and symptoms include:

  • Red, itchy, swollen or scratchy eyes
  • Mucous, sticky discharge
  • Tearing
  • Photophobia (sensitivity to light)
  • Swollen eyelids
  • Crusting and sticking of eyelids
  • Foreign body sensation
  • Enlarged lymph nodes behind the ears

How to tell the difference between Chlamydia Conjunctivitis and other forms of conjunctivitis?

As Chlamydia Conjunctivitis presents very similarly to viral and other bacterial conjunctivitis, it is not possible to tell the difference based on eye signs and symptoms alone. For this reason, many patients may have been previously treated, or self-medicated, with various types of eye drops without symptomatic relief. A diagnosis of Chlamydia Conjunctivitis is usually suspected if close questioning reveals genito-urinary symptoms, or if the sexual partners of these patients have similar eye symptoms.

Who is at risk?

Chlamydia can affect anyone who is sexually active, both males and females alike, regardless of sexual preference or orientation. Young people may be at higher risk for various reasons, including practices like inconsistent condom usage.

Diagnosis

Chlamydia Conjunctivitis is usually diagnosed based on history and examination of the eye. If necessary, a swab test of the conjunctiva can be performed. Your doctor may advise you to test for other STIs as well.

STD Screening Singapore | Rapid STD Test for Chlamydia and Gonorrhoea PCR

Treatment for Chlamydia Conjunctivitis

If left untreated, Chlamydia Conjunctivitis resolves spontaneously in 6 to 18 months, but most individuals would seek treatment due to the severity of the symptoms. Chlamydia Conjunctivitis is treated with topical antibiotics such as tetracycline, erythromycin and fluoroquinolones, but due to the high probability of concomitant genital tract infection, oral antibiotic therapy is recommended. Sexual partners of the patients should be contacted, evaluated and treated.

Prevention

  • Wash your hands regularly, avoid touching or rubbing your eyes unless your hands are clean
  • Do not share eye makeup or cosmetics with anyone
  • Refrain from sharing towels, washcloths, pillows, or sheets with anyone. If one of your eyes is affected but not the other, use a separate towel for each eye
  • Observe safe sexual practices including consistent and correct usage of condoms, reducing your number of partners or being in a mutually monogamous relationship where you are aware of your partner’s sexual health status
  • Regular STI screening helps you remain aware of your own sexual health status

Neonatal Chlamydia Conjunctivitis

Although relatively harmless in adults, Chlamydia Conjunctivitis can have severe health consequences in children. Infection is acquired from an infected mother during vaginal delivery, from exposure to the bacteria in the birth canal. Chlamydia Trachomatis is responsible for up to 40% of conjunctivitis in neonates. If left untreated, neonatal conjunctivitis can cause blindness.

The symptoms usually develop within 1 day to 2 weeks after birth and typically include redness of the conjunctiva, eyelid swelling, and mucous discharge. At least half of neonates with Chlamydia Conjunctivitis also have the bacteria present in the nasopharynx, and some go on to develop Chlamydia pneumonia. Therefore, oral antibiotic therapy is the treatment of choice in neonatal Chlamydia Conjunctivitis as it can also target concomitant nasopharyngeal infection.

The condition can be prevented by undergoing prompt screening and treatment if a genital infection is suspected during pregnancy. Deliveries should be conducted under hygienic conditions taking all aseptic measures. The newborn baby’s closed lids should be thoroughly cleansed and dried.

Next Read: Common STD Incubation Periods

Pain During Ejaculation

What does it feel like?

Pain during ejaculation is also known as dysejaculation, odynorgasmia, post orgasmic pain, dysorgasmia or orgasmalgia. This can range from mild discomfort to severe pain and can occur during or after ejaculation. The usual sites of pain are the penis (along the shaft or at the tip), scrotum, perineal or perianal area.

The pain can last anywhere from a few minutes up to 24 hours. Dysejaculation can be associated with other sexual dysfunctions. It can significantly impair a person’s quality of life and sex life through reduction of the individual’s self-esteem and sexual desire.

Several studies demonstrated its prevalence between 1–10% in the general population, but this may be underreported due as the discomfort may be transient and mild for some people.The prevalence may increase to 30–75% among men who suffer from chronic prostatitis or chronic pelvic pain syndrome. It is also seen in other conditions mentioned below.

Causes 

There are a variety of conditions that can result in painful ejaculations, but it can also be an idiopathic problem with no identifiable cause. Sexually transmitted infections, calculi or stones in the seminal vesicles, damage to the pelvic nerves, inflammation of prostate, prostate cancer, benign prostatic hyperplasia, prostate surgery, pelvic radiation, a previous history of hernia repair or rectal intercourse and certain medications such as antidepressants have all been associated with dysorgamia. 

Psychological issues may also be the cause of painful ejaculations, especially if the patient does not experience this problem during masturbation. Other rarer causes include heavy metal or mercury toxicity or ciguatera toxin fish poisoning.
Also read: 7 Common Causes For Painful Ejaculation

Evaluation

Just with all types of sexual problems, the doctor will start with a thorough medical and sexual history. A history regarding sexually transmitted diseases, relationship issues, psychological or psychiatric issues and drug intake will be taken. The doctor will also be keen to assess any urinary symptoms, prostatic diseases, familial prostate cancer, previous surgical procedures (e.g., hernia repair or prostatectomy) and previous history of radiotherapy. 

Your doctor may do a prostate exam to look for any pain, swelling or nodules which may indicate a prostate pathology. A neurological and musculoskeletal examination may detect a nervous system pathology.

Investigations your doctor might do include a urine or semen culture looking for any infections, especially with sexually transmitted infections. Blood tests for prostate specific antigen (PSA) levels may be raised if it is a prostate issue. Ultrasound scans may also be ordered. No obvious pathology is detected in a significant number of patients. 

Treatment options

Treatment of painful ejaculation should be directed at managing the underlying cause if there is one. 

If an infection is detected, antibiotics will be given. Urological procedures may be done for prostate growth or cancers. If drugs are a suspected cause, changing the medications or stopping it can be considered. Your doctor may prescribe medical treatment such as muscle relaxants, α-blockers, anti-inflammatory agents, certain types of antidepressants and neuropathic pain medications to alleviate the symptoms. Psychotherapy or relationship counselling should be conducted for patients with an underlying psychological issue. Behavioural therapies and pelvic floor exercises have also shown to be helpful. Extracorporeal shockwave therapy (ESWT) can be done for pelvic pain and dysorgasmia which can also alleviate the pain.

If you do experience pain during ejaculation, it is important to seek medical attention and treatment to rule out serious causes and before this issue impairs your sexual function and quality of life. 

Next read: Dysuria (Painful Urination)

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Dysuria (Painful Urination)

What is Dysuria (Painful Urination)?

Dysuria is the sensation of pain, burning, or discomfort on urination. The pain may be in the lower part of the abdomen, along the length of the penis in males or at the urethral opening in females. It is a symptom which can be due to many different conditions. 


Causes of Dysuria (Painful Urination)

The most common cause of acute dysuria is infection, especially cystitis (infection of the bladder). Other infectious causes include urethritis (infection of the urinary tube) and vaginitis (infection of the vaginal canal). Infections of the prostate may also cause dysuria. These can be due to sexually transmitted infections (STI) or non-STI infections. 

Non-infectious causes can include a foreign body in the urinary tract, certain medication use, urinary tube anatomic abnormalities, trauma, and bladder pain syndrome. Certain autoimmune and psychogenic conditions can cause dysuria as well. 

Dysuria may be accompanied by other symptoms including urinary frequency and urgency, vaginal or penile discharge, pain during sexual intercourse, foul-smelling or blood stained urine, fever and swollen groin lymph nodes.  


Evaluation

The doctor will usually start off with taking a history and performing a physical examination. Crucially, the doctor will also order up some urine tests to be done. These tests can usually tell us the exact organism that is causing the infection. Depending on what the doctor might suspect, other investigations such as radiological investigations (x-rays, ultrasounds or CT scans) and blood tests may be done. If necessary, a urologist may do a scope of the bladder (cystoscopy) as well.


Treatment for Painful Urination

Most of the time, the reason is usually due to a bacterial infection of the urinary tract. For bacterial infections, antibiotics are given to kill off the infection. The type and duration of antibiotics depends on the type of bacteria. Antibiotics in the form of an injection may be given as well. 

If the cause of dysuria is due to a STI, it is imperative that we ensure the bacteria is eliminated completely, and that your sexual partners are tested and treated as well. It is also recommended to screen for other STIs. 

Other symptomatic treatment for dysuria can include medications to ease the discomfort on urination or the other symptoms like urinary frequency and urgency. While these medications do not clear the bacteria by itself, when used in conjunction with the antibiotics, they can provide much needed relief for symptoms that can otherwise be very uncomfortable.

If you do experience dysuria, do not hesitate and seek medical attention and treatment early.

Next read: Vaginal Piercings

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